Structural disease modification in axial spondyloarthritis

Abstract

"Disease modification" in axial spondyloarthritis (axSpA) seeks to not only alleviate clinical symptoms but also alter the disease's natural course by impeding new bone formation. Recent years have witnessed the effectiveness of treatments, including biologics and nonsteroidal anti-inflammatory drugs, in managing axSpA symptoms. Emerging evidence points toward their potential impact on slowing structural disease progression. This comprehensive review centers on the pivotal role of inhibiting new bone formation in axSpA disease modification. It delves into the significance of imaging techniques for assessing disease progression and explores the disease-modifying properties of available axSpA treatments, encompassing NSAIDs, TNF inhibitors, IL-17 inhibitors, and JAK inhibitors. This article offers valuable insights into the evolving landscape of disease modification strategies in axial spondyloarthritis, highlighting the multifaceted approaches used to attain these objectives.

Keywords: Ankylosing spondylitis; Antirheumatic agents; Axial spondylarthritis; Diagnostic imaging; Disease progression; Imaging; Non-Steroidal anti-inflammatory agents; Outcomes assessment; Radiographic progression; Risk factors; Smoking; Spondylarthritis; Structural progression; Tumor necrosis factor-alpha.