Robinson, P. C., Sengupta, R. and Siebert, S. (2019) Non-radiographic axial spondyloarthritis (nr-axSpA): advances in classification, imaging and therapy. Rheumatology and Therapy, 6(2), pp. 165-177. (doi: 10.1007/s40744-019-0146-6) (PMID:30788779) (PMCID:PMC6514020)
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Abstract
Non-radiographic axial spondyloarthritis (nr-axSpA) is a recently described form of axial inflammatory arthritis that has not caused substantial erosive damage to the sacroiliac joints. Nr-axSpA is associated with significant impairment in quality of life and, in a proportion of patients, it can evolve into ankylosing spondylitis (AS, also termed radiographic axSpA). The identification in the clinic of nr-axSpA has been made possible by advances in magnetic resonance imaging (MRI). Classification criteria for nr-axSpA have been proposed but there remains discussion in the international community regarding this. Studies are ongoing to further define the classification and diagnosis of nr-axSpA. There is much further research required regarding the optimal use of MRI in nr-axSpA, including distinguishing sacroiliac MRI changes in the normal population and the definition of a positive MRI in spinal disease. Non-steroidal anti-inflammatory drugs and physiotherapy are the core first-line therapy for nr-axSpA. Tumour necrosis factor inhibitors also play a very important role in treatment of patients with active nr-axSpA who do not respond to first-line therapy. Agents directed at interleukin-17, interleukin-23 and Janus kinase inhibitors are proving effective in AS with ongoing and planned studies in nr-axSpA. A great deal of active research is being undertaken in classification, imaging and therapy in nr-axSpA and so the future for improving the lives of patients with nr-axSpA is promising.
| Item Type: | Articles |
|---|---|
| Keywords: | Ankylosing spondylitis, axial spondyloarthritis, magnetic resonance imaging, non-radiographic axial spondyloarthritis, tumour necrosis factor inhibitor. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Siebert, Professor Stefan |
| Authors: | Robinson, P. C., Sengupta, R., and Siebert, S. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Infection & Immunity |
| Research Centre: | College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology |
| Journal Name: | Rheumatology and Therapy |
| Publisher: | Springer |
| ISSN: | 2198-6576 |
| ISSN (Online): | 2198-6584 |
| Published Online: | 20 February 2019 |
| Copyright Holders: | Copyright © 2019 The Authors |
| First Published: | First published in Rheumatology and Therapy 6(2):165-177 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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