Non-Radiographic Axial Spondyloarthritis

Chronic inflammatory conditions affecting the axial joints which cannot be detectable on x-rays. It is characterized by pain, stiffness of joints and inflammation. Non-radiographic axial spondyloarthritis can have symptoms onset before the age of 45 and progress to more severe ANKYLOSING SPONDYLITIS over time.

Also Known As:

Networked: 185 relevant articles (31 outcomes, 58 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Sieper, Joachim: 17 articles (01/2022 - 01/2008)
2.	van der Heijde, Désirée: 16 articles (01/2022 - 06/2013)
3.	Maksymowych, Walter P: 14 articles (09/2022 - 06/2013)
4.	Deodhar, Atul: 13 articles (09/2022 - 01/2016)
5.	Rudwaleit, Martin: 13 articles (09/2022 - 01/2008)
6.	Dougados, Maxime: 11 articles (01/2022 - 06/2013)
7.	Baraliakos, Xenofon: 10 articles (04/2022 - 09/2012)
8.	Poddubnyy, Denis: 10 articles (01/2021 - 08/2011)
9.	Braun, Jürgen: 9 articles (01/2021 - 08/2011)
10.	Landewé, Robert: 8 articles (01/2022 - 01/2016)

Drugs and Biologics

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

1.	Adalimumab (Humira)FDA Link 01/01/2018 - "The ABILITY-3 study explored the ability to withdraw adalimumab treatment in patients with non-radiographic axial spondyloarthritis who achieved sustained clinical remission after open-label treatment with adalimumab. " 01/01/2019 - "Predictors of remission in patients with non-radiographic axial spondyloarthritis receiving open-label adalimumab in the ABILITY-3 study." 06/01/2016 - "The Food and Drug Agency (FDA) had criticized the ASAS criteria and the studies which used these criteria to enroll patients in a clinical trial of certolizumab and adalimumab for the treatment of non-radiographic axial spondyloarthritis. " 01/01/2016 - "Data are from ABILITY-1, a phase 3 trial of adalimumab vs placebo in nr-axSpA patients. " 06/01/2013 - "Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1)."
2.	Certolizumab PegolFDA Link 07/24/2013 - "Rapid effectiveness of certolizumab pegol in non-radiographic axial spondyloarthritis." 01/01/2022 - "Long-term safety and clinical outcomes of certolizumab pegol treatment in patients with active non-radiographic axial spondyloarthritis: 3-year results from the phase 3 C-axSpAnd study." 09/01/2022 - "We evaluated clinical responses to certolizumab pegol (CZP) in patients with nr-axSpA stratified by baseline MRI/CRP status. " 10/29/2021 - "Predictors of long-term clinical response in patients with non-radiographic axial spondyloarthritis receiving certolizumab pegol." 01/01/2017 - "Two hundred and eighteen of 325 patients randomized (AS: 121; nr-axSpA: 97) received certolizumab pegol from week 0. "
3.	Tumor Necrosis Factor InhibitorsIBA 01/01/2014 - "TNF antagonists seemed as effective in controlling symptoms in patients with nr-axSpA. " 01/01/2018 - "Poor efficacy of TNF inhibitors in non-radiographic axial spondyloarthritis in the absence of objective signs: A bicentric retrospective study." 01/01/2021 - "Tumor necrosis factor inhibitor (TNFi) has been used as a highly effective treatment in patients with AS and has shown good efficacy and safety in clinical trials in patients with nr-axSpA. " 01/01/2020 - "TNF inhibitors were used in 87.8% patients with AS and 78.3% with nr-axSpA (p=0.04). " 12/01/2019 - "81% voted against the initiation of TNF inhibitors in nr-axSpA patients with normal CRP levels and normal MRI. "
4.	Interleukin-17 (Interleukin 17)IBA 03/01/2021 - "A biological agent targeting interleukin-17 was approved for nr-axSpA by the Pharmaceutical and Medical Devices Agency (PMDA) in August 2020. " 01/01/2023 - "RCT (n=15) data on efficacy of interleukin-17 inhibitors (IL-17i) demonstrated clinically relevant effects (risk ratio vs placebo to achieve ASAS40 response 1.3-15.3 (r-axSpA, n=9), 1.4-2.1 (nr-axSpA, n=2)). " 01/01/2022 - "Concerns have been raised that randomized placebo-controlled trials (RCTs) in non-radiographic axial spondyloarthritis (nr-axSpA) might be failing to identify patients that best show differences in clinical response rates between those receiving active drug and those receiving placebo therapies; in addition, some studies might even be showing spurious differences in responses to TNF and IL-17 inhibitor therapies. " 09/01/2023 - "Five trials (all nr-axSpA) were included: three with tumor necrosis factor inhibitors (TNFi, N = 729) and two with interleukin-17 inhibitors (IL-17i, N = 794). " 01/01/2020 - "We aimed to evaluate the efficacy and safety of ixekizumab, an IL-17 inhibitor, in non-radiographic axial spondyloarthritis. "
5.	Etanercept (Enbrel)FDA Link 07/01/2018 - "In this subset of patients with nr-axSpA from Latin America, Central/Eastern Europe, and Asia, treatment with etanercept, compared with placebo, resulted in improved disease symptoms and patient HRQoL. " 10/01/2021 - "The EMBARK trial was a phase 3, randomized, double-blind, placebo-controlled study of etanercept in nr-axSpA. " 01/03/2020 - "This was a post-hoc analysis of data from the EMBARK study in patients with nr-axSpA treated with etanercept. " 01/01/2018 - "Modification of structural lesions on MRI of the sacroiliac joints by etanercept in the EMBARK trial: a 12-week randomised placebo-controlled trial in patients with non-radiographic axial spondyloarthritis." 07/01/2016 - "Clinical and MRI responses to etanercept in early non-radiographic axial spondyloarthritis: 48-week results from the EMBARK study."
6.	golimumabFDA Link 01/01/2016 - "In one ongoing, well-designed controlled study (GO-AHEAD), data at 16 weeks showed that treatment with golimumab (50 mg every 4 weeks) was effective in improving the clinical signs and symptoms of disease in nr-axSpA patients. " 01/01/2022 - "Long-term tolerability and efficacy of golimumab in active non-radiographic axial spondyloarthritis: results from open-label extension." 06/01/2018 - "Cost-effectiveness Analysis of Golimumab in the Treatment of Non-Radiographic Axial Spondyloarthritis in Scotland." 06/01/2017 - "Thus, golimumab is an effective, generally well tolerated and potentially convenient option for the treatment of RA, PsA, AS and nr-axSpA in adults, and pJIA in children." 01/01/2016 - "Although additional long-term data are needed, current evidence indicates that golimumab is an effective option for the treatment of nr-axSpA. "
7.	C-Reactive ProteinIBA 10/04/2023 - "Thirty patients with nr-axSpA (seven women (90%), with a mean age of 46.07 ± 10.48 years old and C-reactive protein (CRP) 2.26 ± 2.14 mg/L) were randomly divided into two groups: A (n1 = 15 patients) and B (n2 = 15 patients). " 01/01/2022 - "From 2080 patients, those with nr-axSpA (n=485) and r22axSpA (n=443) presented with lower C reactive protein levels and less severe clinical spinal involvement compared with patients with r3+axSpA (n=1152). " 03/01/2021 - "AS and nr-axSpA share various demographic and clinical features and disease burden, although sex and objective inflammatory findings such as elevated serum C-reactive protein level are slightly different between AS and nr-axSpA. " 01/01/2021 - "We also identified a positive correlation between fJSW and BME in patients with nr-axSpA and normal serum levels of C-reactive protein (phi score of 0.362 and p = 0.001). " 01/01/2021 - "AS patients were older showing more CV risk factors and higher values of C reactive protein and erythrocyte sedimentation rate (ESR) than those with nr-axSpA. "
8.	upadacitinibIBA 01/01/2022 - "Upadacitinib significantly improved the signs and symptoms of non-radiographic axial spondyloarthritis compared with placebo at week 14. " 11/13/2023 - "The safety profiles of upadacitinib in nr-axSpA mirrored those in other indications, underscoring its potential as a promising treatment option for nr-axSpA. " 08/01/2023 - "Effect of Upadacitinib on Quality of Life and Work Productivity in Active Non-radiographic Axial Spondyloarthritis: Results From Randomized Phase 3 Trial SELECT-AXIS 2." 01/01/2022 - "Between Nov 26, 2019, and May 20, 2021, 314 patients with active non-radiographic axial spondyloarthritis were enrolled into the study, and 313 received study drug (156 in the upadacitinib group and 157 in the placebo group); 295 (94%) patients (145 in the upadacitinib group and 150 in the placebo group) received treatment for the full 14 weeks. " 01/01/2022 - "Upadacitinib for the treatment of active non-radiographic axial spondyloarthritis (SELECT-AXIS 2): a randomised, double-blind, placebo-controlled, phase 3 trial."
9.	secukinumabIBA 10/01/2020 - "Secukinumab effective for nr-axSpA." 01/01/2023 - "Two-year imaging outcomes from a phase 3 randomized trial of secukinumab in patients with non-radiographic axial spondyloarthritis." 01/01/2021 - "Secukinumab in non-radiographic axial spondyloarthritis: subgroup analysis based on key baseline characteristics from a randomized phase III study, PREVENT." 05/01/2023 - "This BIA accounted for the new indication of secukinumab in nr-axSpA patients, reporting no significant changes in the required budget and adding an effective treatment option. " 05/01/2023 - "In nr-axSpA patients, secukinumab reported no significant budget increase (+ 1.0%). "
10.	ixekizumabIBA 09/25/2021 - "Treatment with ixekizumab improved sleep, work productivity, and activity impairment in patients with nr-axSpA. " 09/25/2021 - "COAST-X ( NCT02757352 ) was a 52-week, phase 3, multicenter, randomised placebo-controlled trial evaluating 80-mg ixekizumab every 2 weeks and every 4 weeks in patients with active non-radiographic axial spondyloarthritis. " 09/25/2021 - "Ixekizumab improves sleep and work productivity in patients with non-radiographic axial spondyloarthritis: results from the COAST-X trial at 52 weeks." 03/01/2021 - "Ixekizumab Improves Patient-Reported Outcomes in Non-Radiographic Axial Spondyloarthritis: Results from the Coast-X Trial." 01/01/2021 - "In a COAST-X study, ixekizumab was superior to a placebo for improving signs and symptoms in patients with nr-axSpA at weeks 16 and 52. "

Therapies and Procedures

1.	Therapeutics 06/01/2020 - "The objective of this study was to investigate biologic use and reasons for switching therapy among patients with nr-axSpA in the US. " 06/01/2019 - "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." 06/01/2019 - "Non-steroidal anti-inflammatory drugs and physiotherapy are the core first-line therapy for nr-axSpA. " 03/01/2017 - "Anti-TNF therapy has demonstrated similar efficacy and safety in nr-axSpA and AS. " 01/01/2017 - "Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. "
2.	Exercise Therapy (Therapy, Exercise) 11/25/2016 - "The efficacy of exercise therapy for ankylosing spondylitis (AS) is well-documented, but dearth of information is for non-radiographic axial spondyloarthritis (nr-axSpA). " 01/01/2019 - "We found that exercise therapy mainly in the nr-axSpA improves PROs, but not ECM turnover biomarkers. " 01/01/2019 - "At baseline, increased levels of CRPM were found in r-axSpA (14.85 ± 4.10) compared to nr-axSpA (11.83 ± 3.20), p < 0.05, but all three biomarkers were not influenced by exercise therapy. "
3.	Drug Tapering 09/01/2020 - "C-OPTIMISE assessed achievement of sustained clinical remission in patients with axSpA, including radiographic (r) and non-radiographic (nr) axSpA, during certolizumab pegol (CZP) treatment, and subsequent maintenance of remission following CZP dose continuation, dose reduction or withdrawal. "
4.	Biological Therapy 07/01/2020 - "Predictors of poor BASDAI50 response: Presence of nr-axSpa [RR 2.12 (1.01-4.51), p=0.05], female gender [RR 2.14 (1.20-3.82), p=0.01] and history of biologic therapy [RR 3.52 (1.95-6.33), p<0.001]. " 06/01/2020 - "Use and Switching of Biologic Therapy in Patients with Non-Radiographic Axial Spondyloarthritis: A Patient and Provider Survey in the United States." 11/01/2018 - "Data suggest that, after the issue of the new classification criteria for SpA, biological therapy is being administered earlier than previously in SpA patients and in a higher proportion of patients with nr-axSpA. " 01/01/2020 - "To evaluate if the gender distribution and clinical pattern of patients with axSpA initiating biological therapy (BT) was modified in clinical practice after its approval for non radiographic-axSpA (nr-axSpA). " 01/01/2020 - "We aimed to perform a structured literature review of spinal radiographic progression, as assessed by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), in patients with ankylosing spondylitis (AS) or nonradiographic axial spondyloarthritis (nr-axSpA) treated with biologic therapy. "
5.	Retreatment 11/02/2023 - "Efficacy and safety of golimumab in patients with non-radiographic axial spondyloarthritis: a withdrawal and retreatment study (GO-BACK)." 01/01/2023 - "RE-EMBARK investigated etanercept (ETN) withdrawal and retreatment in patients with nonradiographic axial spondyloarthritis (nr-axSpA) achieving inactive disease. "