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Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis.
Intern Med J 2015; 45(2):127-33IM

Abstract

The field of spondyloarthritis (SpA) has seen huge advances over the past 5 years. The classification of axial disease has been redefined by the axial SpA criteria that incorporate disease captured before radiographic damage is evident as well as established erosive sacroiliac joint disease. Our knowledge of genetics and basic immunological pathways has progressed significantly. In addition, revolutionary progress has been achieved with the availability of tumour necrosis factor inhibitors for treating patients with moderate to severe disease. In parallel, several of novel biomarkers have been identified that show significant promise for the future. Advances in magnetic resonance imaging have helped define positive disease. We have identified that T1 and short tau inversion recovery sequences are best for the diagnosis of axial SpA, and gadolinium contrast is not additive for diagnosis. Progress has been made in identifying potential agents and strategies that reduce radiographic progression. Several referral strategies aimed at appropriate identification of patients have been trialled and found to be effective. There is still substantial work ahead, but the advances of the last 5 years have made a huge and tangible difference at the clinical coalface, and we suggest that this trend will continue.

Authors+Show Affiliations

University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Department of Rheumatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25132517

Citation

Robinson, P C., and H Benham. "Advances in Classification, Basic Mechanisms and Clinical Science in Ankylosing Spondylitis and Axial Spondyloarthritis." Internal Medicine Journal, vol. 45, no. 2, 2015, pp. 127-33.
Robinson PC, Benham H. Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis. Intern Med J. 2015;45(2):127-33.
Robinson, P. C., & Benham, H. (2015). Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis. Internal Medicine Journal, 45(2), pp. 127-33. doi:10.1111/imj.12544.
Robinson PC, Benham H. Advances in Classification, Basic Mechanisms and Clinical Science in Ankylosing Spondylitis and Axial Spondyloarthritis. Intern Med J. 2015;45(2):127-33. PubMed PMID: 25132517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis. AU - Robinson,P C, AU - Benham,H, PY - 2014/06/30/received PY - 2014/07/26/accepted PY - 2014/8/19/entrez PY - 2014/8/19/pubmed PY - 2015/11/3/medline KW - ankylosing spondylitis KW - anti-TNF KW - axial spondyloarthritis KW - classification criteria KW - magnetic resonance imaging KW - spondyloarthritis SP - 127 EP - 33 JF - Internal medicine journal JO - Intern Med J VL - 45 IS - 2 N2 - The field of spondyloarthritis (SpA) has seen huge advances over the past 5 years. The classification of axial disease has been redefined by the axial SpA criteria that incorporate disease captured before radiographic damage is evident as well as established erosive sacroiliac joint disease. Our knowledge of genetics and basic immunological pathways has progressed significantly. In addition, revolutionary progress has been achieved with the availability of tumour necrosis factor inhibitors for treating patients with moderate to severe disease. In parallel, several of novel biomarkers have been identified that show significant promise for the future. Advances in magnetic resonance imaging have helped define positive disease. We have identified that T1 and short tau inversion recovery sequences are best for the diagnosis of axial SpA, and gadolinium contrast is not additive for diagnosis. Progress has been made in identifying potential agents and strategies that reduce radiographic progression. Several referral strategies aimed at appropriate identification of patients have been trialled and found to be effective. There is still substantial work ahead, but the advances of the last 5 years have made a huge and tangible difference at the clinical coalface, and we suggest that this trend will continue. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/25132517/Advances_in_classification_basic_mechanisms_and_clinical_science_in_ankylosing_spondylitis_and_axial_spondyloarthritis_ L2 - https://doi.org/10.1111/imj.12544 DB - PRIME DP - Unbound Medicine ER -