Spondyloarthropathies: Diagnosis and Treatment

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2023-12
Authors
Becker, Emily
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Greenlee, Heather
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Brown, Gayle
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Abstract
Arthritis, a group of debilitating diseases causing irreversible joint damage, encompasses various forms. This review focuses on spondyloarthropathies (SpAs), a subset affecting the axial skeleton, particularly ankylosing spondylitis (AS) and psoriatic arthritis (PsA). SpAs are characterized by inflammation of sacroiliac and axial joints, enthesitis, and the presence of the HLA-B27 gene. Understanding the intricacies of PsA and AS diagnosis is crucial due to the permanent joint and bone damage associated with these diseases. This review explores proposed mechanisms behind PsA and AS pathogenesis, including the role of cytokines, ossification of connective tissue, and angiogenesis. Despite the complexity of these mechanisms, current research provides valuable insights. Treatment strategies aim at symptom reduction and slowing disease progression, as there is no identifiable cause. Non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs) constitute conventional treatments. Biologics, particularly TNF inhibitors and interleukin inhibitors, have been revolutionary, with JAK inhibitors and PDE4 inhibitors emerging as effective alternatives. Patient access to treatment is hindered by financial barriers, necessitating the exploration of cost-effective solutions to improve outcomes for individuals with spondyloarthropathies.
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2023