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Spondyloarthritis (SpA) is a complex polygenic disorder with mixed clinical phenotype. Pro-inflammatory cytokines, including tumour necrosis factor (TNF), interleukin (IL)-17 and IL-23, play key pathogenetic roles in SpA, with their blockade being effective in many, but not all cases. Inhibition of IL-6 effectively suppresses synovitis in rheumatoid arthritis (RA)1 but has failed to show efficacy in ankylosing spondylitis (AS), the prototype SpA, in two controlled clinical trials.2 ,3 This is surprising since genetic and experimental studies indicate a potential role for IL-6 in some SpA subsets.4–6 Here, we report our experience in four men with AS and severe, recurrent peripheral synovitis. Detailed clinical and laboratory characteristics are summarised in table 1 but briefly they all fulfilled the modified New York criteria for AS with two cases (2 and 4) …
Contributors MM wrote the manuscript; GdM contributed to the writing and editing; MP contributed one of the clinical cases; DGM contributed scientific input; HM-O conceived the idea for the manuscript and contributed three of the cases. All authors edited the manuscript and approved the final version.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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