Vinod Chandran1,2,3,4,5. 1. Division of Rheumatology, Department of Medicine. 2. Department of Laboratory Medicine and Pathobiology. 3. Institute of Medical Science, University of Toronto. 4. Krembil Research Institute, University Health Network, Toronto. 5. Department of Medicine, Memorial University of Newfoundland, St. John's, Canada.
Abstract
PURPOSE OF REVIEW: Of the four musculoskeletal domains of psoriatic arthritis (PsA), the axial domain is the least studied. With the advent of targeted therapy that is efficacious in some but not all manifestations of spondyloarthritis (SpA), there is interest in understanding the similarities and differences between axial PsA (axPsA) and ankylosing spondylitis. Moreover, there is also interest in evaluating the axial domain in PsA clinical trials, domain that has traditionally been ignored in such studies. This review aims to summarize the current understanding of the differences between ankylosing spondylitis and axPsA. RECENT FINDINGS: Recent observational studies have shown that axPsA forms part of the SpA spectrum, flanked by peripheral PsA on one side and ankylosing spondylitis on the other. Thus, axial disease is more severe in ankylosing spondylitis, whereas peripheral disease is more severe in axPsA. However, the overall disease burden and impact is similar. The expression of axPsA is influenced by age, disease duration, sex and HLA-B27 status. SUMMARY: axPsA has not been properly defined hampering research into pathogenesis, disease impact and treatment. Research to define prevalence, clinical features, impact, similarities and differences with other axial SpA, and treatment is an unmet need.
PURPOSE OF REVIEW: Of the four musculoskeletal domains of psoriatic arthritis (PsA), the axial domain is the least studied. With the advent of targeted therapy that is efficacious in some but not all manifestations of spondyloarthritis (SpA), there is interest in understanding the similarities and differences between axial PsA (axPsA) and ankylosing spondylitis. Moreover, there is also interest in evaluating the axial domain in PsA clinical trials, domain that has traditionally been ignored in such studies. This review aims to summarize the current understanding of the differences between ankylosing spondylitis and axPsA. RECENT FINDINGS: Recent observational studies have shown that axPsA forms part of the SpA spectrum, flanked by peripheral PsA on one side and ankylosing spondylitis on the other. Thus, axial disease is more severe in ankylosing spondylitis, whereas peripheral disease is more severe in axPsA. However, the overall disease burden and impact is similar. The expression of axPsA is influenced by age, disease duration, sex and HLA-B27 status. SUMMARY: axPsA has not been properly defined hampering research into pathogenesis, disease impact and treatment. Research to define prevalence, clinical features, impact, similarities and differences with other axial SpA, and treatment is an unmet need.
Authors: Denis Poddubnyy; Xenofon Baraliakos; Filip Van den Bosch; Jürgen Braun; Laura C Coates; Vinod Chandran; Torsten Diekhoff; Floris A van Gaalen; Lianne S Gensler; Niti Goel; Alice B Gottlieb; Désirée van der Heijde; Philip S Helliwell; Kay Geert A Hermann; Deepak Jadon; Robert G Lambert; Walter P Maksymowych; Philip Mease; Peter Nash; Fabian Proft; Mikhail Protopopov; Joachim Sieper; Murat Torgutalp; Dafna D Gladman Journal: Ther Adv Musculoskelet Dis Date: 2021-12-18 Impact factor: 5.346
Authors: Francesca Motta; Andrea Pederzani; Maria Cristina Carena; Angela Ceribelli; Paul B Wordsworth; Maria De Santis; Carlo Selmi; Matteo Vecellio Journal: Curr Rheumatol Rep Date: 2021-07-03 Impact factor: 4.592