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Aktueller Stand der Therapieansätze bei Spondylarthropathien

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Umsetzung neuer Therapien in der rheumatologischen Praxis und Versorgung

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Zusammenfassung

Trotz der Bedeutung der Spondylarthropathien im täglichen klinischen Alltag gibt es wenige etablierte Therapieansätze. Dieser Mangel ist vor allen Dingen frappierend bei der ankylosierenden Spondylitis, der häufigsten Erkrankung innerhalb der Spondylarthropathien, die auch den schwersten Verlauf aufzeigen kann. Sulfasalazin wirkt höchstens bei frühen Formen der ankylosierenden Spondylitis, während es bei der Manifestation einer peripheren Arthritis bei allen Formen der Spondylarthropathien wirksam ist. Die nahezu dramatische Besserung der Symptome bei späten Verlaufsformen der ankylosierenden Spondylitis unter einer Therapie mit dem TNFα-blockierenden Antikörper Infliximab zeigt neue Therapiewege auf und lässt durchaus Optimismus aufkommen, dass für diese chronisch-entzündliche Erkrankung Behandlungsansätze gefunden werden, ähnlich wie es sehr erfolgreich in der letzten Dekade für die rheumatoide Arthritis gelungen ist. Hierfür wird der Verbund innerhalb des Kompetenznetzes Rheuma in Deutschland eine wichtige Stütze sein.

Summary

Anti-TNF therapy seems to be highly effective in AS. Based on the available results, this treatment seems to be at least as effective as in RA. Furthermore, because no other treatments are available for AS — in contrast to RA or psoriatic arthritis — infliximab might even become a first-line immunosuppresive treatment in patients with severe, active AS. A dosage of 5 mg/kg seems to be required and intervals between 6–12 weeks seem to be necessary depending on the disease activity. It remains to be shown what the long-term effects are, whether the patients benefit from long-term therapy and whether radiological progression and ankylosis can be stopped. Allergy, lupus-like diseases and tuberculosis are rare side effects which need to be addressed. At first glance, the possible benefits of anti-TNF therapy seem to outweigh these shortcomings.

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Author information

Authors and Affiliations

  1. Med. Klinik I Rheumatologie, Univeritätsklinikum Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Prof. Dr. J. Sieper

  2. Rheumazentrum Ruhrgebiet, Herne, Germany

    J. Braun

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  2. J. Braun
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Editors and Affiliations

  1. Klinikum für Innere Medizin IV, Klinikum der Friedrich Schiller Universität, Erlanger Allee 101, 07740, Jena, Deutschland

    Gert Hein

  2. Rheumazentren in der DGRh, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    Henning Zeidler (Sprecher der Arbeitsgemeinschaft Regionaler Kooperativer) & István Meznerits (Koordinator der Geschäftsstelle Regionaler Kooperativer) (Sprecher der Arbeitsgemeinschaft Regionaler Kooperativer) &  (Koordinator der Geschäftsstelle Regionaler Kooperativer)

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© 2002 Steinkopff Verlag

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Sieper, J., Braun, J. (2002). Aktueller Stand der Therapieansätze bei Spondylarthropathien. In: Hein, G., Zeidler, H., Meznerits, I. (eds) Umsetzung neuer Therapien in der rheumatologischen Praxis und Versorgung. Steinkopff. https://doi.org/10.1007/978-3-642-85445-3_6

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  • DOI: https://doi.org/10.1007/978-3-642-85445-3_6

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1334-1

  • Online ISBN: 978-3-642-85445-3

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