: Spondyloarthritis (SpA) refers to a group of disorders sharing common clinical, genetic and imaging characteristics. Axial (ax) SpA corresponds to a subgroup that mainly affects the axial skeleton, leading to inflammatory back pain and progressive radiographic changes of the sacroiliac joints and the spine. axSpA are currently subdivided into two forms, namely the radiographic and nonradiographic form, and are associated with musculoskeletal pain, restriction of spinal mobility, specific extra-articular features and overall, altered quality of life. The therapeutic management of axSpA has considerably progressed and is now well standardized. : Herein, the author reviews the pharmacological treatments that may be used in axSpA, including radiographic and nonradiographic forms in addition to the role of nonsteroidal anti-inflammatory drugs (NSAIDs), TNF alpha (TNFi), and IL-17A (IL-17Ai) inhibitors. : NSAIDs remain the mainstay of initial therapy and biological agents may be then envisaged. TNFi and IL-17Ai may be used in axSpA, but physicians have more experience with TNFi. Only TNFi are licensed for the treatment of nonradiographic axSpA. IL-17Ai may be used as first or second line biologic disease modifying antirheumatic drugs (bDMARDs) and further results are needed to better define their position in the therapeutic management of axSpA.
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http://dx.doi.org/10.1080/14656566.2019.1617853 | DOI Listing |
Acta Radiol
January 2025
Department of Radiology, Selcuk University Medical Faculty, Konya, Turkey.
Background: Piriformis syndrome, an often-overlooked cause of sciatica, commonly presents as chronic gluteal pain and poses a diagnostic challenge, particularly in patients with axial spondyloarthritis (axSpA).
Purpose: To examine piriformis muscle abnormalities on sacroiliac magnetic resonance imaging (MRI) and their association with clinical outcomes in patients with axSpA.
Material And Methods: This cross-sectional study included 100 axSpA patients (50 radiographic [r-axSpA], 50 non-radiographic [nr-axSpA]), classified by the 2009 ASAS Axial Spondyloarthritis criteria, who underwent MRI evaluations of the sacroiliac joints over a 6-month period.
Tunis Med
January 2025
Department of Rheumatology, Kassab Institute of Orthopaedics, Mannouba. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Aim: To elaborate Tunisian recommendations for the therapeutic management in current practice of patients with spondyloarthritis who are candidates for treatment with a biological agent.
Methods: Following the standardized procedures of the INEAS (Instance Nationale de l'Evaluation et de l'Accréditation en Santé) and in collaboration with the LITAR (Tunisian League against Rheumatism), a systematic review of the literature, carried out by 6 rheumatologists, based on the questions individualized by the working group (15 expert rheumatologists), served as the basis for the working meetings, with determination of the strength of the recommendations and the degree of agreement of the experts. The recommendations were validated by an independent reading group comprising 19 experts from various related specialties.
Rheumatology (Oxford)
January 2025
Department of Medicine/Rheumatology, University of California, San Francisco, California, USA.
Objectives: Bimekizumab, a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)‑17F in addition to IL-17A, previously demonstrated efficacy and was well tolerated to 1 year in patients with non-radiographic (nr-) and radiographic (r-) axial spondyloarthritis (axSpA). Here, we report bimekizumab safety and efficacy to 2 years.
Methods: Patients completing week 52 in the phase 3 studies BE MOBILE 1 (nr-axSpA; NCT03928704) and 2 (r‑axSpA; NCT03928743) were eligible for an ongoing open‑label extension (OLE; NCT04436640).
Acta Med Philipp
November 2024
Department of Medicine, Makati Medical Center.
Axial Spondyloarthritis (SpA) is a chronic inflammatory disease of the spine associated with the gene HLA-B27. Non-radiographic spondyloarthritis (nr-SpA), an early stage of axial SpA often goes unrecognized in many settings including the Philippines. We describe five Filipinos from a tertiary health care facility who fulfill the Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for non-radiographic SpA with the aim of increasing awareness of this disease in the Philippines.
View Article and Find Full Text PDFCurr Rheumatol Rep
December 2024
Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 143-729, Republic of Korea.
Purpose Of Review: We aimed to introduce recent finding of imaging studies used in axial spondyloarthritis (axSpA).
Recent Findings: Using low-dose whole spine CT (CT syndesmophyte score [CTSS]) improved diagnostic accuracy for evaluating spinal structural progression than previous method (modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]) in axSpA. The novel definition of positive finding of sacroiliac joint (SIJ) and spine magnetic resonance imaging (MRI) enabled to diagnose axSpA earlier than plain radiography.
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