Advertisement

Axial Spondyloarthritis

  • Adam Berlinberg
  • Kristine A. KuhnEmail author
Chapter

Abstract

Spondyloarthritis is an overlapping family of inflammatory arthritides without known serologic markers that are characterized by the presence of enthesitis and new bone formation. While the majority of conditions affect the spine, peripheral joint involvement also may occur. Diagnosis involves a thorough history, physical exam, and imaging studies. Although treatment modalities are evolving, NSAIDs remain a hallmark of treatment. TNF-α inhibitors are frequently used and specific interleukin inhibitors are becoming more prevalent. Patients with spondyloarthritis require long-term monitoring and frequently require physical and occupational therapy.

Keywords

Spondyloarthritis Ankylosing spondylitis Inflammatory back pain Psoriatic arthritis Enthesitis 

References

  1. 1.
    Zochling J, Smith EU. Seronegative spondyloarthritis. Best Pract Res Clin Rheumatol. 2010;24(6):747–56.CrossRefGoogle Scholar
  2. 2.
    Kehl AS, Corr M, Weisman MH. Review: enthesitis: new insights into pathogenesis, diagnostic modalities, and treatment. Arthritis Rheumatol. 2016;68(2):312–22.CrossRefGoogle Scholar
  3. 3.
    Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379–90.CrossRefGoogle Scholar
  4. 4.
    Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Curr Allergy Asthma Rep. 2015;15(1):489.CrossRefGoogle Scholar
  5. 5.
    Reveille JD. Genetics of spondyloarthritis--beyond the MHC. Nat Rev Rheumatol. 2012;8(5):296–304.CrossRefGoogle Scholar
  6. 6.
    Jethwa H, Abraham S. The evidence for microbiome manipulation in inflammatory arthritis. Rheumatology (Oxford). 2017;56(9):1452–60.Google Scholar
  7. 7.
    Reveille JD, Witter JP, Weisman MH. Prevalence of axial spondylarthritis in the United States: estimates from a cross-sectional survey. Arthritis Care Res (Hoboken). 2012;64(6):905–10.CrossRefGoogle Scholar
  8. 8.
    Carter ET, McKenna CH, Brian DD, Kurland LT. Epidemiology of ankylosing spondylitis in Rochester, Minnesota, 1935-1973. Arthritis Rheum. 1979;22(4):365–70.CrossRefGoogle Scholar
  9. 9.
    Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford). 2014;53(4):650–7.CrossRefGoogle Scholar
  10. 10.
    Stolwijk C, Boonen A, van Tubergen A, Reveille JD. Epidemiology of spondyloarthritis. Rheum Dis Clin N Am. 2012;38(3):441–76.CrossRefGoogle Scholar
  11. 11.
    Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, et al. The development of assessment of spondyloArthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777–83.CrossRefGoogle Scholar
  12. 12.
    Mease PJ, Van den Bosch F, Sieper J, Xia Y, Pangan AL, Song IH. Performance of 3 enthesitis indices in patients with peripheral spondyloarthritis during treatment with adalimumab. J Rheumatol. 2017;44(5):599–608.CrossRefGoogle Scholar
  13. 13.
    Ward MM, Deodhar A, Akl EA, Lui A, Ermann J, Gensler LS, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis research and treatment network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2016;68(2):282–98.CrossRefGoogle Scholar
  14. 14.
    Sieper J, Lenaerts J, Wollenhaupt J, Rudwaleit M, Mazurov VI, Myasoutova L, et al. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, part 1. Ann Rheum Dis. 2014;73(1):101–7.CrossRefGoogle Scholar
  15. 15.
    Chen J, Liu C. Sulfasalazine for ankylosing spondylitis. Cochrane Database Syst Rev. 2005;2:CD004800.Google Scholar
  16. 16.
    Chen J, Veras MM, Liu C, Lin J. Methotrexate for ankylosing spondylitis. Cochrane Database Syst Rev. 2013;2:CD004524.Google Scholar
  17. 17.
    Ash Z, Gaujoux-Viala C, Gossec L, Hensor EM, FitzGerald O, Winthrop K, et al. A systematic literature review of drug therapies for the treatment of psoriatic arthritis: current evidence and meta-analysis informing the EULAR recommendations for the management of psoriatic arthritis. Ann Rheum Dis. 2012;71(3):319–26.CrossRefGoogle Scholar
  18. 18.
    Baraliakos X, van den Berg R, Braun J, van der Heijde D. Update of the literature review on treatment with biologics as a basis for the first update of the ASAS/EULAR management recommendations of ankylosing spondylitis. Rheumatology (Oxford). 2012;51(8):1378–87.CrossRefGoogle Scholar
  19. 19.
    Haroon N, Inman RD, Learch TJ, Weisman MH, Lee M, Rahbar MH, et al. The impact of tumor necrosis factor alpha inhibitors on radiographic progression in ankylosing spondylitis. Arthritis Rheum. 2013;65(10):2645–54.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Guillot X, Prati C, Sondag M, Wendling D. Etanercept for treating axial spondyloarthritis. Expert Opin Biol Ther. 2017;17(9):1173–81.CrossRefGoogle Scholar
  21. 21.
    Hueber W, Sands BE, Lewitzky S, Vandemeulebroecke M, Reinisch W, Higgins PD, et al. Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn’s disease: unexpected results of a randomised, double-blind placebo-controlled trial. Gut. 2012;61(12):1693–700.CrossRefGoogle Scholar
  22. 22.
    Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev. 2008;1:CD002822.Google Scholar
  23. 23.
    Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol. 1994;21(12):2286–91.PubMedGoogle Scholar
  24. 24.
    Husni ME. Comorbidities in psoriatic arthritis. Rheum Dis Clin N Am. 2015;41(4):677–98.CrossRefGoogle Scholar
  25. 25.
    Walsh JA, Song X, Kim G, Park Y. Evaluation of the comorbidity burden in patients with ankylosing spondylitis using a large US administrative claims data set. Clin Rheumatol. 2018;37(7):1869–78.CrossRefGoogle Scholar
  26. 26.
    Osterhaus JT, Purcaru O. Discriminant validity, responsiveness and reliability of the arthritis-specific work productivity survey assessing workplace and household productivity within and outside the home in patients with axial spondyloarthritis, including nonradiographic axial spondyloarthritis and ankylosing spondylitis. Arthritis Res Ther. 2014;16(4):R164.CrossRefGoogle Scholar
  27. 27.
    Xia Q, Fan D, Yang X, Li X, Zhang X, Wang M, et al. Progression rate of ankylosing spondylitis in patients with undifferentiated spondyloarthritis: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96(4):e5960.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of RheumatologyUniversity of Colorado School of MedicineAuroraUSA

Personalised recommendations