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.