Abatacept in spondyloarthritis refractory to tumour necrosis factor inhibition

I Olivieri¹, S D’Angelo¹, G A Mennillo¹, G Pistone², E Scarano³ and A Padula¹

¹ Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
² Rheumatology Unit, "Civico e Benfratelli" National Relevance and High Specialization Hospital Trust, Palermo, Italy
³ Radiology Department of San Carlo Hospital of Potenza, Potenza, Italy

Correspondence to:
Dr I Olivieri, Rheumatology Department of Lucania, Ospedale San Carlo, Contrada Macchia Romana, 85100, Potenza, Italy; ignazioolivieri@tiscalinet.it

Accepted 3 October 2008

The first 150 words of the full text of this article appear below.

We report the case of a patient with undifferentiated spondyloarthritis (uSpA) who was successfully treated with abatacept after failing all three available tumour necrosis factor (TNF) antagonists.

Her disease had begun in 2003 with right buttock pain and asymmetrical peripheral arthritis. Human leukocyte antigen (HLA) typing for the B27 antigen, antibodies to cyclic citrullinated peptide and rheumatoid factor were negative. No erosions were observed on x rays of hands and feet. Since MRI of the sacroiliac joints (SI) showed right sacroiliitis, a diagnosis of uSpA with axial and peripheral joint involvement was made.

During the first 4 years of evolution, the disease was unresponsive to different drugs including non-steroidal anti-inflammatory drugs (NSAIDs), oral and intra-articular steroids, methotrexate (MTX), sulfasalazine, cyclosporine, leflunomide, pamidronate, etanercept, infliximab and adalimumab.

In February 2007, the patient presented with right buttock pain, bilateral Achilles enthesitis, tenderness and swelling of the right sternoclavicular joint, both wrists, second . . . [Full text of this article]

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