title: Treatment challenges in axial spondylarthritis and future directions.
abstract: Major progress has been made in recent years in the management of axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Most predictors of response have been defined for TNF-blocker therapy, and new treatment strategies are being discussed about how to best reach remission and how to maintain remission. Other biologics besides TNF-blockers have been tested in AS but have so far failed. The IL-17/IL-23 cytokines currently seem to be the most interesting targets. Short-term TNF-blocker therapy does not inhibit radiographic progression but long-term might do so. NSAIDs have been proven to inhibit such progression, even after 2 years of treatment. The effect of a combined therapy of NSAIDs with TNF-blockers on the inhibition of new bone formation in AS patients is currently unknown.
authors.affiliation: Medical Department I, Rheumatology, Charitè, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. joachim.sieper@charite.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D011379:Prognosis; D011859:Radiography; D025241:Spondylarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha