Innovative approaches in axial spondyloarthritis: exploring emerging trends in treatment and management
DOI:
https://doi.org/10.20883/medical.e1270Keywords:
axial spondyloarthritis, biologics, JAK inhibitors, IL-17 inhibitors, treatment innovations, chronic inflammatory disease, disease managementAbstract
Background. Axial Spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the axial skeleton, resulting in chronic pain, reduced mobility, and potential spinal fusion. Traditional therapies emphasize symptomatic control via nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Recent advances, however, including biologic agents and JAK inhibitors, have opened new therapeutic possibilities.
Methods. A comprehensive literature review was conducted using databases such as PubMed and Scopus. The literature search included English-language publications between January 2018 and February 2024. We included clinical trials, meta-analyses, systematic reviews, cohort studies, and significant basic science studies. Publications outside these criteria or those in other languages were excluded. Methodological rigor and limitations of included studies were critically discussed.
Results. Key recent advances include biologic therapies targeting IL-17 and IL-23 cytokine pathways, demonstrating significant efficacy in inflammation control and functional improvement. Additionally, precision medicine, microbiome-based interventions, and advanced imaging techniques enhance personalized treatment strategies.
Conclusions. Integrating novel pharmacological approaches with lifestyle modifications presents a promising strategy for optimizing axSpA management. Long-term studies are required to assess the full impact of these innovations on disease progression.
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References
Wenker KJ, Quint JM. 1. 2025.
Uslu S, Gulle S, Sen G, Cefle A, Yilmaz S, Kocaer SB, et al. 52. Sci Rep. 2024 Jun 20;14(1):14194.
Parameswaran P, Lucke M. 2. 2025.
Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al. 49. Ann Rheum Dis. 2023 Jan;82(1):19–34.
Poddubnyy D, Heijde D van der. 50. Rheumatic Disease Clinics of North America. 2012 Aug;38(3):601–11.
Evangelatos G, Bamias G, Kitas GD, Kollias G, Sfikakis PP. 4. Rheumatol Int. 2022 Sep;42(9):1493–511.
Coşkun Benlidayı İ. 5. Turk J Phys Med Rehabil. 2020 Mar;66(1):84–7.
Zhu W, He X, Cheng K, Zhang L, Chen D, Wang X, et al. 6. Bone Res. 2019 Aug 5;7(1):22.
Kenyon M, Maguire S, Rueda Pujol A, O’Shea F, McManus R. 7. Rheumatol Int. 2022 Aug 8;42(12):2085–95.
Pedersen SJ, Maksymowych WP. 8. Curr Rheumatol Rep. 2019 Oct 11;21(10):58.
Li Z, Akar S, Yarkan H, Lee SK, Çetin P, Can G, et al. 51. PLoS Genet. 2019 Apr 4;15(4):e1008038.
Fei Y, Yu H, Wu Y, Gong S. 9. Arthritis Res Ther. 2024 Jan 16;26(1):24.
Agrawal P, Tote S, Sapkale B. 10. Cureus. 2024 Jan;16(1):e52559.
Alotaibi A, Albarrak D, Alammari Y. 11. Cureus. 2024 Mar;16(3):e55459.
Wang R, Maksymowych WP. 14. Front Immunol. 2021;12:715510.
Khan MA. 12. In: Ankylosing Spondylitis and Axial Spondyloarthritis. Oxford University PressOxford; 2023. p. 124–7.
Yin Y, Wang M, Liu M, Zhou E, Ren T, Chang X, et al. 13. Arthritis Res Ther. 2020 Dec 12;22(1):111.
Paroli M, Caccavale R, Paroli MP, Spadea L, Accapezzato D. 15. Int J Mol Sci. 2023 Jan 5;24(2):1027.
Weaver CT, Hatton RD, Mangan PR, Harrington LE. 16. Annu Rev Immunol. 2007 Apr 1;25(1):821–52.
Li H, Tsokos GC. 18. Clin Rev Allergy Immunol. 2021 Feb 13;60(1):31–45.
Deodhar A, Van den Bosch F, Poddubnyy D, Maksymowych WP, van der Heijde D, Kim TH, et al. 21. The Lancet. 2022 Jul;400(10349):369–79.
19. The Journal of Clinical Pharmacology. 2020 Apr 20;60(4):551–551.
Van den Bosch F, Deodhar A, Poddubnyy D, Maksymowych WP, van der Heijde D, Kim T, et al. 20. ACR Open Rheumatol. 2024 Aug 15;6(8):470–80.
Deodhar A, van der Heijde D, Sieper J, Van den Bosch F, Maksymowych WP, Kim T, et al. 17. Arthritis & Rheumatology. 2022 Jan 12;74(1):70–80.
Li Z, Brown MA. 22. Clin Transl Immunology. 2017 Dec;6(12).
23. Nat Genet. 2013 Jul 9;45(7):730–8.
Brown MA, Wordsworth BP. 24. Best Pract Res Clin Rheumatol. 2017 Dec;31(6):763–76.
Kenyon M, Maguire S, Rueda Pujol A, O’Shea F, McManus R. 26. Rheumatol Int. 2022 Aug 8;42(12):2085–95.
Saveanu L, Carroll O, Lindo V, Del Val M, Lopez D, Lepelletier Y, et al. 25. Nat Immunol. 2005 Jul 1;6(7):689–97.
Hanson AL, Vukcevic D, Leslie S, Harris J, Lê Cao KA, Kenna TJ, et al. 27. PLoS Genet. 2020 Aug 17;16(8):e1008906.
Peruzzi M, Parker KC, Long EO, Malnati MS. 28. J Immunol. 1996 Oct 15;157(8):3350–6.
Forbes JD, Van Domselaar G, Bernstein CN. 29. Front Microbiol. 2016 Jul 11;7.
Taurog JD, Richardson JA, Croft JT, Simmons WA, Zhou M, Fernández-Sueiro JL, et al. 30. J Exp Med. 1994 Dec 1;180(6):2359–64.
Du X, Li H, Zhao H, Cui S, Sun X, Tan X. 31. PLoS One. 2024 Jul 31;19(7):e0306792.
Wang L, Wei Z, Pan F, Song C, Peng L, Yang Y, et al. 32. Front Immunol. 2023 Feb 23;14.
Filidou E, Kandilogiannakis L, Shrewsbury A, Kolios G, Kotzampassi K. 33. World J Gastroenterol. 2024 Apr 21;30(15):2096–108.
34.
Li M, Dai B, Tang Y, Lei L, Li N, Liu C, et al. 35. mSystems. 2019 Apr 30;4(2).
Wen C, Zheng Z, Shao T, Liu L, Xie Z, Le Chatelier E, et al. 36. Genome Biol. 2017 Dec 27;18(1):142.
Mandl P, Navarro-Compán V, Terslev L, Aegerter P, van der Heijde D, D’Agostino MA, et al. 37. Ann Rheum Dis. 2015 Jul;74(7):1327–39.
Khmelinskii N, Regel A, Baraliakos X. 39. Front Med (Lausanne). 2018 Apr 17;5.
Ożga JK, Mężyk E, Kmiecik W, Wojciechowski W, Żuber Z. 40. Rheumatology. 2024 Jul 12;62(3):196–206.
Østergaard M, Lambert RGW. 41. Ther Adv Musculoskelet Dis. 2012 Aug 28;4(4):301–11.
Matsubara K, Ibaraki M, Nemoto M, Watabe H, Kimura Y. 42. Ann Nucl Med. 2022 Feb 14;36(2):133–43.
Artesani A, Bruno A, Gelardi F, Chiti A. 43. Eur Radiol Exp. 2024 Feb 7;8(1):17.
Feng X, Qiao J, Xu W. 44. Postgrad Med J. 2023 Oct 19;99(1177):1138–47.
Aboul-Soud MAM, Alzahrani AJ, Mahmoud A. 45. Cells. 2021 Sep 5;10(9):2319.
Li A, Tao Y, Kong D, Zhang N, Wang Y, Wang Z, et al. 46. Exp Ther Med. 2017 Aug;14(2):1538–46.
Dilip Kumar S, Aashabharathi M, KarthigaDevi G, Subbaiya R, Saravanan M. 47. Mol Biol Rep. 2022 Jan 23;49(1):657–73.
Li ZH, Wang J, Xu JP, Wang J, Yang X. 48. Mil Med Res. 2023 Mar 10;10(1):12.
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