Abstract

The spondyloarthropathies (SpA) are a heterogenous group of diseases associated with axial and peripheral arthritis, enthesitis, inflammatory bowel disorders, presence of HLA B27 antigen and often with iridocyclitis. The aim of our study was to assess the efficacy of infliximab (chimeric monoclonal IgG 1 anti-TNF-alpha antibody) in the treatment of three patients with SpA. In two male patients (45- and 50-year old) psoriatic arthritis was diagnosed 28 and 22 years ago, and in 22-year old man ankylosing spondylitis was found before eight years. In all three cases dramatic response, almost complete resolution of joint manifestations and in patients with psoriatic arthritis regression of skin eruptions typical for psoriasis after one or two infusions was observed. In our opinion, the most optimal schedule of infliximab infusions was administration of the drug at weeks 0, 2, 6 and then every six weeks for at least 12 months. Discontinuation of therapy is associated with recurrence of symptoms of joint inflammation and increase in skin eruptions in patients with psoriatic arthritis within a few months.