Drug Treatment of Enthesis Related Diseases
Painkillers and non-steroid anti-inflammatory drugs (NSAIDs) may help mechanical or degenerative
related enthesopathy and also help the primary inflammatory enthesitis that is typical of Ankylosing
Spondylitis, Psoriatic Arthritis and the related the Spondyloarthropathies. The role of conventional
therapies that work in Rheumatoid Arthritis including Methotrexate and Sulphasalasine has been a
disappointment for the enthesitis related types of arthritis. Despite the spectacular success of
the Anti-TNF therapies, patients may develop resistance to these agents and some patients only partially
respond. The fact that many cases have ongoing enthesopathy while on therapy is increasingly recognised.
Newer agents that block the IL23/IL17 axis and small molecules including PDE4 antagonists are showing
considerable promise for the enthesitis associated disorders.
When patients with advanced cancer take alternative medicines there is no obvious
improvement. Nobody with a heart attack takes alternative remedies but seek life saving
clot busting drugs ....