title: Updated guidelines for the management of axial disease in psoriatic arthritis.
abstract: Axial involvement in patients with psoriatic arthritis (PsA) remains common and can be defined in terms of spinal disease alone or in combination with peripheral manifestations. Diagnosis is based upon inflammatory spinal symptoms or the presence of radiological sacroiliitis and other radiographic signs of spondylitis, or by criteria for axial spondyloarthritis (SpA) defined by ASAS (Assessment of SpondyloArthritis International Society). Although recent data are scarce for efficacy of traditional therapies for axial disease (e.g., nonsteroidal antiinflammatory drugs, methotrexate, etc.), limited data are available for targeted biologics and novel agents. We identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA. This review is an update of the axial PsA section of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute. drpnash@tpg.com.au.
authors.forename: Peter
authors.initials: P
authors.lastname: Nash
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cauli
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute.
authors.forename: William J
authors.initials: WJ
authors.lastname: Taylor
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Olivieri
authors.affiliation: From the Department of Medicine, University of Queensland, Australia; Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy; and University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.P. Nash, MBBS (Hons), FRACP, Department of Medicine, University of Queensland; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Cauli, MD, PhD, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; W.J. Taylor, MBChB, PhD, FRACP, Rehabilitation Teaching and Research Unit, University of Otago; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Toronto Western Research Institute.
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D001368:Axis, Cervical Vertebra; D001688:Biological Products / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012955:Societies, Medical / Q000592:standards; D025241:Spondylarthritis / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D001688:Biological Products
keywords: AXIAL; PSORIATIC ARTHRITIS; SPONDYLOARTHRITIS; THERAPY