BIW: twice weekly; BSA: body surface area; CRP: C-reactive protein; ESS: effective sample size; ETN: etanercept; HAQ-DI: Health Assessment Questionnaire Disability Index; MCS: mental component summary; PBO: placebo; PCS: physical component summary; PsA: psoriatic arthritis; SD: standard deviation; SEC: secukinumab; SF-36: 36-Item Short-Form Health Survey; SJC: swollen joint count; TJC: tender joint count; TNFi
: tumor necrosis factor inhibitor Supplementary Table 2.
A conditional recommendation to treat with a TNFi
over treatment with secukinumab, ixekizumab or tofacitinib, and a conditional recommendation to treat with seukinumab or ixekizumab over tofacitinib.
This relationship was investigated in 917 patients with PsA taking either ustekinumab or TNFi
agents approved for treatment of ax-SpA exist in our country; infliximab, ETA, adalimumab, golimumab, certolizumab, and CT-P13, an infliximab biosimilar.
Similarly, the analysis of results derived from clinical studies evaluating the changing pattern of visfatin after treatment with TNFi
showed conflicting results.
Triple therapy is considerably less costly than the MTX + TNFi
therapy, but it involves a more complicated regimen of multiple pills taken daily.
To limit AS progression, a large array of pharmacological treatments are currently used, nonsteroidal anti-inflammatory drugs being the mainstay and tumor necrosis factor inhibitors (TNFi
) the best suitable alternative in nonresponsive patients unless there is an absolute contraindication [10,11].
Of interest, TNF inhibitors (TNFi
) have a beneficial effect in delaying radiographic damage in RA patients, even in the absence of clinical improvement, suggesting a specific effect of TNF inhibition, independent of inflammation control .
It is nowadays used as first line or when traditional DMAIRs and / or Tumor necrosis factor inhibitor (TNFi
They found that women are likely to flare without them and need more prednisolone, which is associated with preterm birth and other problems, while an increasing body of evidence suggests that treatment with a tumor necrosis factor inhibitor (TNFi
) is relatively safe during pregnancy.
There are currently eight registered biologic drugs in South Africa (SA), of which four are tumour necrosis factor alpha inhibitors (TNFi
) and four are non-TNFi, including ustekinumab, which is currently registered for the treatment of psoriasis but not for the arthritides (Table 1).