How is peripheral spondyloarthritis treated?

Updated: Feb 02, 2021
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Pharmacologic treatment for peripheral spondyloarthritis includes the following:

  • Nonsteroidal anti-inflammatory drugs
  • Corticosteroid injections
  • Sulfasalazine
  • TNFi (infliximab, etanercept, adalimumab, certolizumab, golimumab)
  • IL-17i (secukinumab, ixekizumab)

In a study of adult patients with recent-onset peripheral spondyloarthritis (symptom duration < 12 weeks), early use of the TNFi golimumab resulted in sustained clinical remission in 49 of 60 patients (82%). Most patients (n=30) fulfilled criteria for sustained clinical remission by week 24. On follow-up at least 18 months after drug withdrawal, 26 of the 49 patients (53%) were still in drug-free remission. [102, 103] Similar data have been seen with all the TNFi and IL-17i.  IL-12/23i are effective in the peripheral arthritis and enthesitis of PsA but do not seem to be effective in axial disease such as is seen in AS.


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