Axial Spondyloarthritis

A spectrum of chronic inflammatory conditions affecting the axial joints (e.g., SPINE), characterized by pain, stiffness of joints (ANKYLOSIS), reduced mobility and inflammation. When joint inflammation and damage are visible on regular X-rays it is called ANKYLOSING SPONDYLITIS; otherwise it is referred to as NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS. HLA-B27 ANTIGEN is a biomarker and IL-23/IL-17 pathway a potential therapeutic target for axial and other related spondyloarthritis.

Also Known As:

Networked: 1106 relevant articles (148 outcomes, 301 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Axial Spondyloarthritis
2.	Psoriatic Arthritis
3.	Ankylosing Spondylitis
4.	Inflammation (Inflammations)
5.	Non-Radiographic Axial Spondyloarthritis

Experts

1.	Sieper, Joachim: 61 articles (06/2022 - 01/2008)
2.	van der Heijde, Désirée: 59 articles (10/2022 - 02/2011)
3.	Poddubnyy, Denis: 54 articles (06/2022 - 07/2012)
4.	Dougados, Maxime: 50 articles (11/2022 - 02/2011)
5.	Baraliakos, Xenofon: 46 articles (11/2022 - 10/2012)
6.	Maksymowych, Walter P: 31 articles (11/2022 - 02/2011)
7.	Rudwaleit, Martin: 29 articles (06/2022 - 01/2008)
8.	Deodhar, Atul: 27 articles (11/2022 - 06/2014)
9.	Østergaard, Mikkel: 25 articles (11/2022 - 08/2011)
10.	Landewé, Robert: 25 articles (01/2021 - 10/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Axial Spondyloarthritis:

1.	Non-Steroidal Anti-Inflammatory Agents (NSAIDs)IBA 01/01/2016 - "Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for patients with symptomatic axial spondyloarthritis (SpA), who seem to respond best if treated early in the course of disease. " 01/01/2017 - "MRI of the SI joints was performed at baseline and week 4. All outcomes except for CRP and MRI scores improved significantly after 4 weeks of NSAIDs, with no difference between axSpA subgroups. " 06/01/2018 - "This randomized controlled study demonstrated that tapering NSAIDs and DMARDs by 50% in patients with axSPA in sustained remission is a feasible treatment strategy. " 01/01/2018 - "To assess the efficacy of long-term treatment with nonsteroidal antiinflammatory drugs (NSAIDs) on bone marrow oedema (BMO) of the sacroiliac joint in newly diagnosed axial spondyloarthritis (SpA) with a symptom duration of less than 4 years, a single-center, open-label study in a cohort of consecutive patients with newly diagnosed axial SpA was conducted. " 01/01/2023 - "In 2003, the first biological disease-modifying drug (bDMARD) was licensed for axSpA which substantially improved outcomes in comparison to NSAIDs. "
2.	Tumor Necrosis Factor InhibitorsIBA 12/01/2016 - "TNF-blockers have been shown to be highly effective in the treatment of active axSpA. " 04/10/2012 - "TNF blockers, it seems already, are at least similarly effective in patients with non-radiographic axSpA as in those with established AS. " 02/01/2017 - "Efficacy of TNF inhibitors has been assessed in randomized controlled trials in axSpA, which included patients who had non-radiographic axSpA according to the ASAS classification criteria. " 11/28/2022 - "The impact of a csDMARD in combination with a TNF inhibitor on drug retention and clinical remission in axial spondyloarthritis." 01/01/2019 - "The use of TNF inhibitors has improved our ability to achieve remission or low disease activity in AxSpA. "
3.	Etanercept (Enbrel)FDA Link 03/01/2021 - "Transition from reference etanercept to SB4 is effective and safe in patients with stable RA and axSpA." 01/01/2021 - "To investigate the efficacy of 16-week treatment with etanercept (ETN) in patients with suspected nonradiographic axial spondyloarthritis (SpA). " 09/01/2018 - "To evaluate the efficacy of different tapering or discontinuation strategies of etanercept in a cohort of axial spondyloarthritis from South China. " 10/01/2017 - "To evaluate the long-term clinical and imaging efficacy of etanercept in patients with early, active nonradiographic axial spondyloarthritis (SpA). " 01/01/2021 - "The objective of this analysis was to assess long-term clinical efficacy of etanercept in early axSpA [including both non-radiographic and radiographic axSpA forms], who participated in the long-term (until year 10) extension of the ESTHER-trial. "
4.	secukinumabIBA 01/01/2023 - "Secukinumab improved disease activity in axSpA patients, especially in naive, and second-line patients, which was accompanied by high persistence rates up to 24 months." 02/01/2022 - "In conclusion, secukinumab is a largely safe and effective treatment for radiographic and non-radiographic axSpA." 01/01/2023 - "Secukinumab (SEC) received Health Canada approval in 2016 for the treatment of adults with axSpA who have responded inadequately to conventional treatment, and has demonstrated efficacy and safety through extensive clinical trials. " 01/01/2020 - "This study aims to evaluate the efficacy of a T2T strategy in patients with axSpA, with secukinumab as a first-line bDMARD, compared with standard-of-care (SOC) treatment. " 07/01/2018 - "To evaluate short-term efficacy of secukinumab in the management of axSpA. "
5.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 08/01/2012 - "There are 2 groups of drugs that have been shown effective in the treatment of patients with axial spondyloarthritis: nonsteroidal anti-inflammatory drugs and tumor necrosis factor α blockers. " 01/01/2018 - "The Sex Influence on Response to Tumor Necrosis Factor-α Inhibitors and Remission in Axial Spondyloarthritis." 11/15/2017 - "The Sex Influence on Response to Tumor Necrosis Factor-α Inhibitors and Remission in Axial Spondyloarthritis." 01/01/2016 - "Tumor necrosis factor α inhibitors (TNFi) have shown promise in the management of AS and axSpA by targeting the underlying inflammatory process, and providing symptomatic relief. " 02/01/2015 - "Remission in nonradiographic axial spondyloarthritis treated with anti-tumor necrosis factor-α drugs: an Italian multicenter study."
6.	Certolizumab PegolFDA Link 01/01/2023 - "RAPID-axSpA (NCT01087762) was a 204-week phase III trial evaluating the safety and efficacy of certolizumab pegol (CZP) in adult patients with active axSpA. " 06/01/2014 - "In two ongoing, well-designed studies, data at 12 and 24 weeks showed that treatment with certolizumab pegol (200 mg every 2 weeks or 400 mg every 4 weeks) was effective in improving the clinical signs and symptoms of disease, health-related quality of life and productivity in patients with axSpA (the RAPID-axSpA study) or PsA (the RAPID-PsA study), with the improvements maintained during longer-term (48 weeks) treatment. " 09/01/2020 - "Induction of Sustained Clinical Remission in Early Axial Spondyloarthritis Following Certolizumab Pegol Treatment: 48-Week Outcomes from C-OPTIMISE." 01/01/2022 - "In RAPID-axSpA (NCT01087762), a 4-year, phase 3 randomized trial, participants were randomized to certolizumab pegol (CZP; 400 mg loading dose at Weeks 0/2/4 then 200/400 mg every 2/4 weeks) or placebo (PBO) at baseline; PBO-randomized participants switched to CZP at Week 16/24 (denoted PBO-randomized/CZP). " 01/01/2022 - "Certolizumab pegol treatment in axial spondyloarthritis mitigates fat lesion development: 4-year post-hoc MRI results from a phase 3 study."
7.	ixekizumabIBA 01/01/2021 - "Continuing versus withdrawing ixekizumab treatment in patients with axial spondyloarthritis who achieved remission: efficacy and safety results from a placebo-controlled, randomised withdrawal study (COAST-Y)." 05/01/2023 - "Long-Term Safety and Efficacy of Ixekizumab in Patients With Axial Spondyloarthritis: 3-year Data From the COAST Program." 01/01/2023 - "Long-Term Safety and Efficacy of Ixekizumab in Patients With Axial Spondyloarthritis: 3-year Data From the COAST Program." 12/08/2018 - "The primary objective was to compare the proportion of patients achieving an ASAS40 response, a composite measure of clinical improvement in axial spondyloarthritis, at week 16 for both ixekizumab treatment groups versus the placebo group. " 09/22/2023 - "This phase III study aimed to determine the efficacy and safety of ixekizumab for treating Chinese patients with active r-axSpA. "
8.	Antirheumatic Agents (DMARD)IBA 07/01/2022 - "We aimed to evaluate clinical characteristics of patients with axSpA, factors related to remission in treat to target era and predictive factors for biologic disease-modifying anti-rheumatic drug switching. " 11/01/2020 - "Effect of biologic disease-modifying anti-rheumatic drugs targeting remission in axial spondyloarthritis: systematic review and meta-analysis." 11/30/2023 - "Medline and Cochrane databases were systematically searched up to March 2021 for randomized controlled trials (RCTs) performed in patients with PsA or axial spondyloarthritis treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). " 08/01/2023 - "Knowledge mapping of biological disease-modifying anti-rheumatic drugs for axial spondyloarthritis: a bibliometric study." 11/01/2015 - "Few studies have been conducted with the aim of evaluating the effect of conventional DMARD, either alone or in combination, in axSpA. "
9.	Interleukin-17 (Interleukin 17)IBA 06/01/2023 - "Biologic agents targeting TNFα or IL-17 have been the mainstay of treatment for patients with axSpA and an inadequate response to nonsteroidal anti-inflammatory drugs. " 11/01/2019 - "The aim of this study was to evaluate the serum levels of BMP-2 and IL-17A in patients with axSpA and their possible correlations with radiographic damage, disease activity, and function. " 12/01/2023 - "Drug Retention Rate and Factors Associated with Discontinuation of Interleukin-17 Inhibitors in Patients with Axial Spondyloarthritis." 12/01/2023 - "In this review, we describe the characteristics and the interleukin 17 secretion capacity of the T-cell subsets identified in axSpA. " 10/04/2023 - "At Week 52, dual inhibition of IL-17A and IL-17F with BKZ resulted in sustained efficacy across the axSpA spectrum; the safety profile was consistent with the known safety of BKZ. "
10.	Adalimumab (Humira)FDA Link 01/01/2018 - "Clinical and MRI remission in patients with nonradiographic axial spondyloarthritis who received long-term open-label adalimumab treatment: 3-year results of the ABILITY-1 trial." 11/01/2015 - "Clinical characteristics of Japanese patients with axial spondyloarthritis, and short-term efficacy of adalimumab." 01/01/2021 - "In 2 multicenter, randomized, double-blind, placebo-controlled, and active-controlled (bDMARD-naïve only) trials, patients with r-axSpA were randomly assigned to receive 80 mg of IXE [every 2 weeks (Q2W) or every 4 weeks (Q4W)], placebo (PBO), or adalimumab (ADA; bDMARD-naïve only). " 01/01/2018 - "49 patients with axSpA from an investigator-initiated, randomised, placebo-controlled trial of adalimumab underwent spinal MRI at weeks 0/6/24/48. " 12/24/2012 - "Adalimumab was generally well tolerated in clinical trials of non-radiographic axSpA; the adverse event profile was similar to that in patients with AS or other approved indications."

Therapies and Procedures

1.	Therapeutics 01/01/2016 - "Published data indicate that a tapering strategy for anti-TNF therapy is successful in maintaining remission or LDA in most patients with axial spondyloarthritis. " 01/01/2020 - "Rapid expansion of therapies available to treat axSpA could lead to improved disease control and decreased disease burden." 06/01/2018 - "Analysis of relapse rates and risk factors of tapering or stopping pharmacologic therapies in axial spondyloarthritis patients with sustained remission." 11/01/2017 - "In patients who discontinue therapy, remission is not typically sustained, with reported rates of relapse and flare across early RA (48-54%), established RA (2-84%), axial spondyloarthritis (11-53%) and PsA (44.9%). " 01/01/2016 - "In this study, loss of remission and disease flares occurred, respectively, in about 21% and 16% of the patients with axSpA who achieved a state of remission while receiving anti-TNF therapy. "
2.	Drug Tapering 09/01/2015 - "The aim of the study was to assess whether dose reduction of biological treatment in patients with axial spondyloarthritis in sustained remission could be effective to maintain remission or low disease activity at 1 year and to explore baseline differences between patients who remained in remission or low disease activity and patients who relapsed. " 09/01/2015 - "All consecutive patients with axial spondyloarthritis in sustained remission were included and received low doses of anti-TNF-α according to a dose reduction protocol. " 01/01/2019 - "The objective was to determine if dose reduction is non-inferior to full-dose TNFi to maintain low disease activity (LDA) in patients already in remission with TNFi, in axial spondyloarthritis. " 09/01/2015 - "Dose reduction of biological treatment in patients with axial spondyloarthritis in clinical remission: Are there any differences between patients who relapsed and to those who remained in low disease activity?" 10/01/2022 - "Conditional recommendations were made in favour of dose reduction in RA and AxSpA but not in PsA. "
3.	Biological Therapy 01/01/2022 - "Biologic therapy was associated with a significant improvement in quality of life in patients with r-axSpA. " 01/01/2021 - "Randomized Cross Over Study Assessing the Efficacy of Non-invasive Stimulation of the Vagus Nerve in Patients With Axial Spondyloarthritis Resistant to Biotherapies: The ESNV-SPA Study Protocol." 07/01/2013 - "Remission and possible discontinuation of biological therapy in axial spondyloarthritis." 01/01/2023 - "Real-world studies are needed to identify factors associated with response to biologic therapies in patients with axial spondyloarthritis (SpA). " 01/01/2022 - "This study suggests that reporting of recommended composites indices for monitoring axSpA might be associated with higher retention rates of biological therapies."
4.	Retreatment 08/01/2013 - "Long-term efficacy of adalimumab after drug withdrawal and retreatment in patients with active non-radiographically evident axial spondyloarthritis who experience a flare." 01/01/2023 - "Etanercept Withdrawal and Retreatment in Nonradiographic Axial Spondyloarthritis: Results of RE-EMBARK, an Open-Label Phase IV Trial." 02/01/2023 - "Recapture and retreatment rates with ixekizumab after withdrawal of therapy in patients with axial spondyloarthritis: results at week 104 from a randomised placebo-controlled withdrawal study." 02/01/2023 - "To evaluate the recapture of response with open-label (OL) ixekizumab (IXE) retreatment at week 104 in patients with axial spondyloarthritis who flared after withdrawal of IXE therapy. " 01/01/2023 - "RE-EMBARK investigated etanercept (ETN) withdrawal and retreatment in patients with nonradiographic axial spondyloarthritis (nr-axSpA) achieving inactive disease. "
5.	Aftercare (After-Treatment) 06/13/2022 - "TNFi treatment was associated with a time-shifted effect on radiographic spinal progression in axSpA that became evident between years 2 and 4 after treatment initiation." 01/01/2020 - "We conducted a qualitative study based on four mixed group discussions focused on patients with inflammatory arthritis (rheumatoid arthritis [n = 21], axial spondyloarthritis [n = 3] and psoriatic arthritis [n = 1]) participating in a reorganized follow-up care. " 04/06/2023 - "We discuss here treatment outcomes of TNFi cycling versus MoA switching after treatment failure with a first TNFi in patients with inflammatory rheumatic diseases, focusing specifically on rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and juvenile idiopathic arthritis. " 01/01/2022 - "ASDAScrp improved slightly within 6 months after treatment with imrecoxib, and TNFi combined with imrecoxib significantly improved multiple effect indexes in axSpA patients. " 01/01/2022 - "Inflammatory signals in the sacroiliac (SI) joints and the aorta of patients with axial spondyloarthritis (axSpA) were graded by positron emission tomography/computed tomography (PET/CT) imaging before and after treatment with sulfasalazine (SSZ) or adalimumab (ADA). "