Current therapeutic practices in spondyloarthropathies.

Spondyloarthropathies are comprised of a number of diseases that have the following features in common: involvement of the spine with sacroiliitis, peripheral arthritis that is frequently asymmetric, absence of rheumatoid nodule, negative rheumatoid factor, and association with HLA-B27. The most important aspect of spondylitis management is a program of regular exercises, aided by nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Indomethacin and phenylbutazone are most effective in AS and RS, although the latter drug should be used with care and only after a trial of other NSAIDs. The mainstay of peripheral arthritis management is the use of NSAIDs and intra-articular corticosteroids, but several delayed-acting drugs (gold, cytotoxic drugs) are beneficial in difficult cases, depending on the type and severity of the disease.