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The use of etanercept as a non-surgical treatment for temporomandibular joint psoriatric arthritis: a case report
- Source :
- Australian Dental Journal. 54:161-165
- Publication Year :
- 2009
- Publisher :
- Wiley, 2009.
-
Abstract
- Psoriatic arthritis (PsA) is a chronic inflammatory disease of the skin and joints characterized by extensive intra-articular bone resorption and silver-red scaly plaques most commonly found on extensor surfaces of the skin. When this arthritis affects the temporomandibular joint (TMJ) and does not successfully halt in its early degenerative process, patients may undergo invasive joint reconstruction that irreversibly changes the TMJ physiologic joint dynamics. This study presents a case of TMJ PsA: anterior open bite, limited range of motion, and erythematous desquamative plaques of the upper limb extensors surfaces. The patient previously received non-steroidal anti-inflammatory drugs, immunosuppressors, and corticosteroids over a four-year period while suffering the idiosyncratic drug side effects from long-term therapy without improvement in joint function or rash resolution. The treatment team then chose etanercept, a synthetic fusion protein therapy that binds with tumor necrosis factor (TNF)-alpha, to interrupt reactive inflammatory arthritis. The patient received the TNF-alpha inhibitor monthly for two years. This last treatment led to full remission of both joint symptomatology and skin lesions. Our results should encourage general dental practitioners' involvement in curing patients with psoriatic arthritis when it affects the TMJ.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
antirheumatic agents
tumor necrosis factor
Inflammatory arthritis
receptors
Arthritis
adult
anti-inflammatory agents
arthritis
complications/drug therapy
drug therapy/etiology
etanercept
humans
immunoglobulin g
immunomodulators
male
non-steroidal
psoriatic
psoriatic arthritis
temporomandibular joint disorders
therapeutic use
tmj
treatment outcome
Receptors, Tumor Necrosis Factor
Etanercept
Psoriatic arthritis
Psoriasis
medicine
General Dentistry
business.industry
Anti-Inflammatory Agents, Non-Steroidal
Arthritis, Psoriatic
medicine.disease
Rash
Surgery
Temporomandibular joint
medicine.anatomical_structure
Upper limb
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 18347819 and 00450421
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Australian Dental Journal
- Accession number :
- edsair.doi.dedup.....1e73803c38999ad7c76e2992c45edfb0