- Chronic back pain is the leading symptom of axial spondyloarthritis (axSpA). Other musculoskeletal manifestations include arthritis, enthesitis and dactylitis. Extra-articular manifestations include anterior uveitis, psoriasis and inflammatory bowel disease (IBD). End-stage patients are recognized by a characteristic stooped posture, sacroiliitis and the presence of syndesmophytes on spine radiographs are characteristic of end-stage patients.
- “axSpA” refers to the whole spectrum of patients with radiographic sacroiliitis (AS or radiographic axSpA) and without radiographic sacroiliitis (non-radiographic axSpA).
- There is still some debate as to whether radiographic and non-radiographic axSpA are two different entities or whether they are associated with a continuous disease spectrum. The current prevailing opinion is that axSpA encompasses one disease spectrum in which patients with nonradiographic axSpA may develop radiographic changes over time. However, not all non-radiographic axSpA patients develop radiographic sacroiliitis. And, not all patients with radiographic sacroiliitis will develop syndesmophytes. The European Medicines Agency proposes to study patients with axSpA as one entity.
- The Assessment of SpondyloArthritis international Society (ASAS) has two sets of treatment recommendations: one for bDMARDs and a second that was established when axSpA was not yet well established.
- Axial Spondyloarthritis Guidelines Updated and Simplified
- Axial Spondyloarthritis Treatment Recommendations (EULAR-ASAS)
Desiree van der Jeijde, Sofia Ramiro, Robert Landewe, et al. “2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis” Annals of the Rheumatic Diseases. 2017;0:1–14. DOI:10.1136/annrheumdis-2016-210770