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.
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.
Compared to other tumour necrosis factor–α inhibitors (TNFi), infliximab remains superior in reducing Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at 12 weeks, results of a network meta-analysis (NMA) have shown. However, it was sensitive to inclusion of an open-label trial, and its efficacy faded at 24 weeks.
A subgroup of patients with HBeAg-negative chronic hepatitis B virus (HBV) infection who ceased their long-term nucleotide analogue treatment maintained virological suppression, pointing to a group of patients who may be suitable for treatment cessation, according to a recent study.