Axial spondyloarthritis: thoughts about nomenclature and treatment targets

CER5998
2012 Vol.30, N°4 ,Suppl.73
PI 0132, PF 0135
D. Specific diseases

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PMID: 23079005 [PubMed]

Received: 14/09/2012
Accepted : 19/09/2012
In Press: 18/10/2012
Published: 20/11/2012

Abstract

The spondyloarthritides (SpA) are a heterogenous group of rheumatic diseases which are genetically linked. The strongest genetic factors, HLA B27, ERAP-1 and IL-23R, are found at variable rates in subgroups. The new nomenclature differentiates predominantly axial SpA (axSpA) from predominantly peripheral SpA (pSpA). Axial SpA (Ax-SpA) is further classified as classical ankylosing spondylitis (AS) and a non-radiographic form, nr-axSpA, which may occur in association with psoriasis (Pso) or chronic inflammatory bowel disease (IBD). Peripheral SpA includes patients with psoriatic arthritis (PsA) and IBD, patients who report a triggering infection (reactive arthritis), and other patients who may be classified simply as `undifferentiated`. The most relevant target of therapy clinically is reduction of disease activity, which is associated with control toward ablation of inflammation, normalisation and/or improvement of function and mobility, prevention of osteoporotic fractures, and inhibition of structural changes (new bone formation) in the spine.