Infliximab in refractory spondyloarthropathies: a multicentre 38 week open study

Some patients (20–30%) with spondyloarthropathies (SpA) have a persistent and disabling disease,1 for which a limited number of alternative therapeutic approaches exist.2 The successful results from randomised, double blind, placebo controlled trials in ankylosing spondylitis (AS) and SpA which have been published 3–5 suggest that treatment with infliximab is highly effective. However, in most of these studies, criteria for the selection of patients are based on active disease, but not on refractory disease (failure of response to previous drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) and disease modifying antirheumatic drugs). Therefore, we aimed at assessing the effectiveness and safety of infliximab in patients with active and refractory SpA. The study was an open label, multicentre, 38 week prospective study in 40 patients with active and refractory SpA: 34 patients had AS, 3 had arthritis with related inflammatory bowel disease, and 3 undifferentiated SpA. Infliximab (5 mg/kg) was given at weeks 0, …