Adalimumab for the treatment of ankylosing spondylitis

Ankylosing spondylitis is a chronic inflammatory disease, with a prevalence of 0.5%, which starts in the third decade of life. Treatment was, until recently, limited. Conventional disease-modifying drugs are not effective for the spinal manifestations, and NSAIDs and physical therapy were the standard treatment, without any other options for patients who did not respond to this treatment. Therefore, the high efficacy of the new group of TNF-blockers for the treatment of active ankylosing spondylitis represents a breakthrough for NSAID-refractory patients. Following the introduction of the two TNF-blockers, infliximab and etanercept, the fully humanized, anti-TNF monoclonal antibody adalimumab is now the third product that has been approved for the treatment of ankylosing spondylitis. Adalimumab is given subcutaneously every 2 weeks at a dose of 40 mg. In open and placebo-controlled trials, the drug was shown to be safe and effective in ankylosing spondylitis patients. Long-term treatment data of up to 2 years are now available, confirming efficacy and acceptable safety.