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Structural disease modification in axial spondyloarthritis
Brona Dinneen1, Finbar O'Shea2, Lianne Gensler3
1Department of Rheumatology, St James's Hospital, Dublin, Ireland.
Best Practice & Research. Clinical Rheumatology
|December 2, 2023
Summary
Disease modification in axial spondyloarthritis (axSpA) aims to halt new bone growth. Current treatments like NSAIDs and biologics show promise in slowing structural progression, offering new hope for patients.
Area of Science:
- Rheumatology
- Immunology
- Orthopedics
Background:
- Axial spondyloarthritis (axSpA) is a chronic inflammatory condition characterized by pain and stiffness.
- Disease modification in axSpA involves not only symptom relief but also inhibiting structural damage, particularly new bone formation.
- Recent advancements in treatments offer potential for altering the disease's natural trajectory.
Purpose of the Study:
- To review the role of inhibiting new bone formation in axSpA disease modification.
- To explore the utility of imaging in assessing disease progression.
- To evaluate the disease-modifying properties of current axSpA treatments.
Main Methods:
- Comprehensive literature review of studies on axSpA treatments and disease modification.
- Analysis of evidence regarding the impact of NSAIDs, TNF inhibitors, IL-17 inhibitors, and JAK inhibitors on bone formation.
- Evaluation of imaging techniques for monitoring structural changes in axSpA.
Main Results:
- Available treatments, including NSAIDs and biologics, demonstrate potential in managing axSpA symptoms and slowing structural progression.
- Inhibiting new bone formation is a key target for achieving disease modification in axSpA.
- Imaging plays a crucial role in assessing treatment efficacy and disease progression.
Conclusions:
- Targeting new bone formation is central to achieving disease modification in axSpA.
- Current therapeutic strategies show promise in altering the structural progression of axSpA.
- Multifaceted approaches are essential for effective disease modification in axial spondyloarthritis.
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