Relevant BNF section: 10.1.3
Up to 2 in 1,000 adults in the UK have ankylosing spondylitis.1–3 This chronic inflammatory disease causes pain and stiffness in the spine and sacroiliac and peripheral joints, and may also affect the eyes, heart and lungs.4 Characteristic features include ankylosis of the spine with a progressive loss of spinal mobility. Treatment with NSAIDs and physical therapy can provide symptomatic relief of pain and stiffness, but does not modify the course of the disease (e.g. slow or prevent ankylosis).2,5 In general, disease-modifying antirheumatic drugs (DMARDs), such as gold, methotrexate and sulfasalazine,* have little or no effect in ankylosing spondylitis.6 ▼Etanercept (Enbrel - Wyeth) and ▼infliximab (Remicade - Schering-Plough), two drugs which block the inflammatory effect of tumour necrosis factor (TNF), are now licensed for the treatment of patients with severe ankylosing spondylitis whose symptoms have not responded adequately to conventional therapy.7,8 Here we review the place of these TNF antagonists in the management of such individuals. * This new spelling reflects the use of recommended International Non-proprietary Names (rINNs) instead of former British Approved Names (BANs), as required by European law. For more information, see the British National Formulary, or http://medicines.mhra.gov.uk/inforesources/productinfo/banslist.pdf
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