Overwhelming response to tumor necrosis factor-? inhibitor infliximab “innovator” versus adalimumab “bio-similar” in a previously therapy naive adult: A case report

ABSTRACT

Therapeutic options for the patient with spondyloarthritis (SpA) are limited. The pharmacotherapy for SpA comprises immunomodulator/suppressive drugs. In this case report, we describe the case of a 29-year-old postgraduate resident in medicine who was diagnosed with SpA and was managed by a combination of various disease-modifying drugs such as methotrexate and sulfasalazine, and immunomodulators such as systemic corticosteroids and tumor necrosis factor (TNF)-? inhibitors. After a series of therapeutic trials with them, the chimeric TNF blocker infliximab led to significant clinical improvement in symptoms and reduction in disease activity