Seronegative spondyloarthropathies: to lump or split?

Area of Science:

• Rheumatology and immunology
• Inflammatory and autoimmune diseases
• Musculoskeletal and connective tissue disorders

Background:

• Recent advances in biological therapies have increased focus on seronegative spondyloarthropathies (SpAs).
• International initiatives are updating the classification and assessment of SpAs.
• A key debate exists between 'lumpers' (SpA as one disease) and 'splitters' (SpA as separate diseases).

Purpose of the Study:

• To review and present evidence regarding the classification debate in seronegative spondyloarthropathies.
• To explore the 'lumpers' versus 'splitters' perspectives on SpA.
• To inform future research and clinical practice in SpA management.

Main Methods:

• Literature review of current research on SpA classification.
• Analysis of evidence supporting unified versus distinct disease models for SpA.
• Synthesis of international efforts in redefining SpA criteria.

Main Results:

• Evidence exists supporting both the 'lumpers' and 'splitters' viewpoints.
• The heterogeneity of clinical presentation complicates a singular classification.
• Ongoing international efforts aim to reconcile these differing perspectives.

Conclusions:

• The classification of seronegative spondyloarthropathies remains a subject of debate.
• Further research is needed to clarify the relationship between different SpA phenotypes.
• A consensus on SpA classification may require integrating evidence from diverse approaches.