Disease Modification in Axial Spondyloarthritis
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Purpose of review
The development of advanced treatment options such as biologic agents for axial Spondyloarthritis (axSpA) has led to increased expectations for modification of clinical outcomes in the long-term course of the disease. In this review, we discuss the objective assessments of disease activity as well as progression and the possible role of the currently available treatment options for modification of the disease course.
The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) continues to be a reliable measure of disease progression. The role of continuous use of NSAIDs remains contentious. Reports have shown the disease-modifying nature of currently available therapies including the anti-TNF agents when used early in the disease course. The benefit has been shown to be evident after at least 4 years of treatment. The anti-IL 17 agents also hold promise for preventing radiographic progression. Newer therapies such as the oral JAK inhibitors need further evaluation.
Disease modification in axial spondyloarthritis which has remained elusive despite clinical improvement with treatment now seems achievable as we start to understand the pathophysiology of this condition better.
KeywordsAxial spondyloarthritis Syndesmophytes mSASSS Disease modification NSAIDs Biologics
Compliance with Ethical Standards
Conflict of Interest
Dr. Pathan reports grants from Merck and personal fees from Celgene outside the submitted work. Padmanabha Shenoy and Xenofon Baraliakos declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
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