title: Structural Disease Progression in Axial Spondyloarthritis: Still a Cause for Concern?
abstract: OBJECTIVE
  Progressive ankylosis is a feared consequence of long-standing axial spondyloarthritis. We aim to critically review current insights into the effect of therapy, the molecular pathways involved in this process, and to present a model explaining the sequence of events.
  
  
  RESULTS
  Long-term follow-up data suggest that successful control of inflammation may slow down radiographic progression of disease in axial spondyloarthritis. Structural effects of new therapies such as interleukin-17 targeting need to be further studied. Bone loss and architectural changes could act as driver for the tissue remodeling process trying to maintain spinal stability in the presence of inflammation. Despite some progress, the nature and mechanisms of new bone formation in axial spondyloarthritis still remain incompletely understood. However, long-term control of inflammation appears critical to avoid progressive disability due to structural damage.
authors.affiliation: Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven & Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Barbara
authors.initials: B
authors.lastname: Neerinckx
authors.affiliation: Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven & Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. Rik.Lories@kuleuven.be.
authors.forename: Rik J
authors.initials: RJ
authors.lastname: Lories
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use; D018450:Disease Progression; D020022:Genetic Predisposition to Disease; D006801:Humans; D010012:Osteogenesis / Q000502:physiology; D025241:Spondylarthritis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001688:Biological Products
keywords: Ankylosing spondylitis; Ankylosis; Axial spondyloarthritis; Bone; Spondyloarthritis; Structural disease progression