Spondyloarthritis refers to a group of inflammatory diseases characterized by spinal & joint oligoarthritis, enthesitis, and sometimes mucocutaneous, ocular and/or cardiac manifestations.
Ankylosing spondylitis is a prototype of spondyloarthritis, particularly of the axial form.
Diagnosis of ankylosing spondylitis is definite if any of the radiological criterion (grade≥2 bilateral sacroiliitis or grade ≥3 unilateral sacroiliitis) is associated with at least one of the clinical criterion (low back pain & stiffness for >3 months that improves with exercise but not relieved by rest, limitation of motion of the lumbar spine in the sagittal and frontal planes, limitation of chest expansion relative to normal values correlated for age and gender.
Use of certolizumab pegol, an antitumour necrosis factor agent, as an add-on medication in patients with active nonradiographic axial spondyloarthritis (nr‐axSpA) confers significant benefits for disease activity, physical function and pain, according to the 52-week data from the phase III C-AXSPAND* trial.
Aerobic training yields no additional benefits for disease activity and functional status in axial spondyloarthritis compared with standard physiotherapy, according to a systematic review and meta-analysis.
Gut inflammation, as indicated by elevated faecal calprotectin levels, may be a marker of more severe disease in patients with axial spondyloarthritis, according to data from the SPARTAKUS cohort. Specifically, increased calprotectin levels are associated with worse disease activity and physical function.
The use of ixekizumab to selectively target interleukin-17A (IL-17A) in disease-modifying antirheumatic drug-naïve patients with ankylosing spondylitis yields improvements in disease activity, health-related quality of life, day-to-day physical activity, and bone marrow oedema of the spine and sacroiliac joint, according to the results of the phase III COAST-V study.
Ixekizumab is safe and effective in the treatment of patients with active radiographic axial spondyloarthritis and previously inadequate response or intolerance to tumour necrosis factor inhibitors, producing rapid and significant improvements in the signs and symptoms, according to the 16-week results of the phase III COAST-W trial.
Aerobic fitness programmes do not confer added benefits for either disease activity or physical function and biological parameters compared with standard physiotherapy in the management of patients with axial spondyloarthritis, a study has found.
Continued therapy with the tumour necrosis factor inhibitor adalimumab appears to yield a higher rate of maintenance of remission in patients with nonradiographic axial spondyloarthritis (axSpa) as opposed to treatment withdrawal, according to the results of the ABILITY-3 study.
Patients with ankylosing spondylitis (AS) derived a greater benefit from tumour necrosis factor (TNF) inhibitors in terms of less radiographic progression when they also took non-steroidal anti-inflammatory drugs (NSAIDs), suggests a cohort study presented at the EULAR 2018 Congress.
The risk of developing acute anterior uveitis or inflammatory bowel disease, but not psoriasis, appears to increase with disease duration in axial spondyloarthritis (AxSpA), and this risk is associated with higher cumulative exposure to inflammation, as reported in a study.
Treatment with tofacitinib yields significant improvements in signs and symptoms of rheumatoid arthritis (RA) in patients from the Asia Pacific, according to data from a posthoc analysis. The drug has a safety profile consistent with global tofacitinib studies, although infections occur more frequently in Asians.
In rheumatoid arthritis (RA) patients in remission, increasing the dose interval of tocilizumab injection from the standard 162 mg once weekly to twice weekly may do more harm than good. Specifically, such a strategy is associated with a lower chance of remission maintenance as well as a lack of improvement in tolerability, as shown in a recent trial.
Physicians are likely to underestimate the severity of psoriatic arthritis (PsA) in patients who are older, show higher fatigue levels, complain of greater pain or have poorer mental health, according to a Singapore study. In contrast, overestimation of disease severity by physicians tends to occur in the presence of higher swollen joint counts.
Patients with early arthritis should be allowed to share in the decision making regarding the approach to treatment, with rheumatologists acting as the primary specialists, according to the 2016 update of the European League Against Rheumatism (EULAR) recommendations for early arthritis management.