Authors: Becker, Heidemarie; Gaubitz, Markus; Domschke, Wolfram; Kucharzik, Torsten

Source: Future Rheumatology, Volume 2, Number 4, August 2007 , pp. 423-431(9)

Publisher: Future Medicine

Abstract:

Joint involvement is the most frequent extraintestinal manifestation of inflammatory bowel diseases (IBDs). Arthralgias are common and spondyloarthropathy may affect peripheral joints and the axial skeleton, as well as the tendons. The broad spectrum of joint manifestations requires a therapeutic concept that takes the potential influence of agents on the underlying bowel disease into consideration. This review will focus on the current therapeutic approach to the different manifestations of IBD-related joint disease and will outline baseline treatment, the use of conventional agents and biologicals. TNF antagonists have dramatically changed the care of patients. In particular, TNF antagonists have emerged as the most effective treatment for ankylosing spondylitis, which has often been refractory to therapy in the past. For patients who fail to respond to TNF antagonists, several novel agents will provide more treatment choices in the future. Recent insights into disease mechanisms of IBD have revealed attractive potential therapeutic targets, such as the interference with immune dysregulation, the gut barrier and the intestinal microbial flora.

Keywords: ankylosing spondylitis; arthritis; Crohn's disease; inflammatory bowel disease; sacroiliitis; spondyloarthritis; spondyloarthropathy; therapy; ulcerative colitis

Document Type: Research article

DOI: http://dx.doi.org/10.2217/17460816.2.4.423

Publication date: 2007-08-01

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• Future Rheumatology provides analysis and commentary on our understanding of disease mechanisms, emerging therapeutic strategies and new diagnostic approaches. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this expanding area of specialization.
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