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Infliximab May Offer Hope For Patients Living With Spondyloarthropathy

March 07, 2002

For the first time, there may be an effective therapeutic option for severe cases of spondyloarthropathies (SpA), a group of rheumatic inflammatory diseases that affect the spinal column, peripheral joints and tendons. The study, published in the March 6 issue of "Arthritis and Rheumatism", found that patients treated with infliximab (also known as REMICADE") monotherapy, experienced median improvements in disease activity of 73 and 78 percent as determined by validated patient and physician global assessment measurement tools, respectively. In comparison, patients treated with placebo experienced virtually no response.

"The future of patients suffering from spondyloarthropathy is hopeful," stated Professor Eric M. Veys, MD, Ghent University Hospital. "It seems as if all requirements have been met to allow us to hope that this treatment will be able to prevent the stiffening of the spinal column and the destruction of the peripheral joints, and that the quality of life of these patients will improve considerably."

Disease Background
Spondyloarthropathies are a group of chronic related disorders of the joints that include ankylosing spondylitis, psoriatic arthritis, and the arthritis associated with inflammatory bowel disease (Crohn's disease or ulcerative colitis). SpA may also include severe inflammation in the eye (uveitis). These diseases affect about 1 percent of the total population and often develop into seriously debilitating conditions with complete stiffening of the spinal column and destruction of the peripheral joints (hips, knees, wrists and/or fingers).

Thus far, treatment of these diseases has been limited to the administration of non-steroidal anti-inflammatory drugs. While these drugs may help to relieve pain for some patients, they do not impact the progression of the disease.

Study Results
Tumor necrosis factor (TNF) is a messenger molecule (cytokine) that is released by stimulated immune cells when inflammation occurs and which, in the case of spondyloarthropathy, induces changes in the bone, joints and tendons. The objective of the 12-week double-blind, placebo-controlled study was to confirm the safety and efficacy of infliximab, a monoclonal antibody that specifically targets TNF-alpha, in forty patients with several sub-types of spondyloarthropathies.

"The results were impressive with regard to subjective complaints, symptoms of inflammation of the spinal column and the peripheral joints, and inflammation markers measured in the blood," stated Prof. Veys.

These results confirm the findings of a separate long-term (more than one year) open-label study initiated by the department of rheumatology of the RUG [State University of Ghent, Belgium], involving intravenous injections of infliximab in 21 patients suffering from various forms SpA (E. Kruithof et al, "Ann Rheum Dis," 2002; 61: 207-212).

Ghent University