Biologic blockade of tumour necrosis factor alpha is an exciting new development in the treatment of the spondyloarthropathies (SpA). Recent reports suggest that both infliximab and etanercept are potent suppressors of inflammation in SpA and this has been confirmed by studies showing suppression of inflammatory indices as well as complete regression or improvement in the inflammatory lesions as shown by magnetic resonance imaging (MRI). Whilst limited follow up data have been reported in the case of infliximab there are no data on how patients on etanercept fare after a years' treatment.
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