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Treatment Challenges in Axial Spondylarthritis and Future Directions

  • SERONEGATIVE ARTHRITIS (MA KHAN, SECTION EDITOR)
  • Published:
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Abstract

Major progress has been made in recent years in the management of axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Most predictors of response have been defined for TNF-blocker therapy, and new treatment strategies are being discussed about how to best reach remission and how to maintain remission. Other biologics besides TNF-blockers have been tested in AS but have so far failed. The IL-17/IL-23 cytokines currently seem to be the most interesting targets. Short-term TNF-blocker therapy does not inhibit radiographic progression but long-term might do so. NSAIDs have been proven to inhibit such progression, even after 2 years of treatment. The effect of a combined therapy of NSAIDs with TNF-blockers on the inhibition of new bone formation in AS patients is currently unknown.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Conflict of Interest

Joachim Sieper has served as a consultant for AbbVie, Merck & Co., Pfizer, UCB, Roche, Sanofi, Eli Lilly and Company, and Janssen Pharmaceutica; has received grant support from AbbVie, Merck & Co., Pfizer, Janssen Pharmaceutica, and Merck-Serono; has received honoraria from AbbVie, Merck & Co., Pfizer, and UCB; has received payment for development of educational presentations (including service on speakers bureaus) from AbbVie, Merck & Co., Pfizer, and UCB; and has had travel/accommodations expenses covered/reimbursed by AbbVie, Merck & Co., Pfizer, and UCB.

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  1. Medical Department I, Rheumatology, Charitè, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Joachim Sieper

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This article is part of the Topical Collection on Seronegative Arthritis

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Sieper, J. Treatment Challenges in Axial Spondylarthritis and Future Directions. Curr Rheumatol Rep 15, 356 (2013). https://doi.org/10.1007/s11926-013-0356-9

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