Overview of Drug Therapy for Spondyloarthritis

Michael P Keith

doi:10.4172/2161-1149.1000119

Abstract

The axial spondyloarthritides (axial SpA) are a related group of disorders prototypically represented by Ankylosing Spondylitis (AS). Reactive arthritis, psoriatic arthritis, enteropathic arthritis and undifferentiated spondyloarthritis are also included in this family. The prevalence of this group of disorders roughly approximates that of ankylosing spondylitis, affecting 1% of the population [1]. Recent updates in classification according to the Assessment of SpondyloArthritis International Society (ASAS) are gaining traction in Rheumatology practice, however some disagreement between clinical diagnosis and ASAS remain [2]. Moreover, ASAS guidelines for classification are shaping the treatment of these conditions [3,4].

Highlights

The axial spondyloarthritides are a related group of disorders prototypically represented by Ankylosing Spondylitis (AS)
Agents used in the management of spondyloarthritis include NonSteroidal Anti-Inflammatory Drugs (NSAIDs), selected non-biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs), and most recently the anti-tumor necrosis factor biologic DMARDs [3]
The treatment of axial spondyloarthritis is evolving with the release of new consensus guidelines occurring every few years

Summary

Introduction

The axial spondyloarthritides (axial SpA) are a related group of disorders prototypically represented by Ankylosing Spondylitis (AS). Psoriatic arthritis, enteropathic arthritis and undifferentiated spondyloarthritis are included in this family The prevalence of this group of disorders roughly approximates that of ankylosing spondylitis, affecting 1% of the population [1]. Though the agents available for treating SpA are similar to those employed in the treatment of rheumatoid arthritis, differences in treatment outcomes for these medications between the two diseases lead to important distinctions. Initial management of these conditions is accessible to non-rheumatologists and ideally will be instituted concomitantly with referral for confirmation of diagnosis and, if needed, adjustment of the treatment regimen. The emphasis is on medical therapies employed according to ASAS guidelines

Outcome Measures in Ankylosing Spondylitis Trials

Traditional DMARDs

Tumor Necrosis Factor Inhibitors

Novel Therapeutic Approaches

Findings

Conclusion