Axial Spondyloarthritis in the Era of Precision Medicine

Rheum Dis Clin North Am. 2020 May;46(2):367-378. doi: 10.1016/j.rdc.2020.01.013.

Abstract

In axial spondyloarthritis (axSpA), the first treatment step is generally a nonsteroidal anti-inflammatory drug, and if insufficient, a biologic is added. Currently, most evidence is available of the biologic tumor necrosis factor-α inhibitors. In patients who have achieved sustained low disease activity, tumor necrosis factor-α inhibitor tapering is considered, although standardized tapering schedules are lacking. In axSpA patients with extra-articular manifestations, the effect of axSpA treatment on these extra-articular manifestations is important to determine the preferred therapy. Overall, it is recommended that treatment of axSpA be individualized based on the most prominent symptoms and presence of extra-articular and peripheral symptoms.

Keywords: Ankylosing spondylitis; Anterior uveitis; Extra-articular manifestations; Spondyloarthritis.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Biological Products / therapeutic use
  • Drug Tapering
  • Humans
  • Precision Medicine / methods*
  • Spondylarthritis / complications
  • Spondylarthritis / drug therapy*

Substances

  • Anti-Inflammatory Agents
  • Biological Products