title: Spondyloarthritis: from unifying concepts to improved treatment.
abstract: Spondyloarthritis (SpA) is a chronic immune-mediated inflammatory disease with diverse phenotypic manifestations including spondylitis, arthritis, enthesitis and extra-articular manifestations (psoriasis, uveitis, inflammatory bowel disease). The common genetic risk factors, the strong familial aggregation and the overlapping immunopathology suggest that these different phenotypic manifestations share common pathogenic pathways. This concept is further strengthened by the good clinical response of all different SpA manifestations to TNF-blocking therapies. However, the phenotypic diversity of SpA is still a major challenge in properly diagnosing, classifying and monitoring the disease and may lead to undertreatment of less typical SpA cases such as undifferentiated SpA. The optimal use of current treatments and the development of novel therapies, including compounds targeting the IL-23/IL-17 axis, thus requires a detailed understanding of both the clinical presentation and the underlying pathogenic pathways in SpA.
authors.affiliation: Department of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Paramarta
authors.affiliation: Department of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. d.l.baeten@amc.uva.nl.
authors.forename: Dominique
authors.initials: D
authors.lastname: Baeten
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods / Q000639:trends; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha
keywords: anti-TNF treatment; axial; biologicals; criteria; pathophysiology; peripheral; spondyloarthritis; treatment