Revista Colombiana de Reumatología
versão impressa ISSN 0121-8123
RESTREPO ESCOBAR, Mauricio et al. The anti-TNF and the radiological progression in ankylosing spondylitis. Rev.Colomb.Reumatol. [online]. 2012, vol.19, n.1, pp. 8-17. ISSN 0121-8123.
The anti-TNF biological agents constitute a major advance in the treatment of patients with ankylosing spondylitis (AS) showing a remarkable improvement in symptoms of patients, their function and quality of life. In addition to this excellent clinical response, it has also been clearly demonstrated improvement of inflammation as evidenced by laboratory tests and MRI studies. Despite this clear evidence, the connection between inflammatory activity and structural progression is not as clearly established as in rheumatoid arthritis, and the evidence of anti-TNF therapy to prevent chronic EA radiological damage is poor. We review the evidence and current theories about this crucial issue and mention the important role of DKK-1 protein, an inhibitor of the Wnt pathway. This protein has recently emerged as a key regulator in bone biology and constitutes a key link between inflammation, osteoporosis and joint remodeling.
Palavras-chave : spondylitis; ankylosing; tumor necrosis factor-alpha inhibitors; radiographic progression; Dickkopf-1 protein.