|Year : 2020 | Volume
| Issue : 5 | Page : 1
Advances in spondyloarthritis: Update 2020
Subramanian Nallasivan1, Vinod Ravindran2
1 Rosemary Mission Hospital, Tirunelveli, Tamil Nadu, India
2 Centre for Rheumatology, Calicut, Kerala, India
|Date of Web Publication||23-May-2020|
Dr. Subramanian Nallasivan
Consultant Rheumatologist, Rosemary Mission Hospital, Vannarpettai, Tirunelveli, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nallasivan S, Ravindran V. Advances in spondyloarthritis: Update 2020. Indian J Rheumatol 2020;15, Suppl S1:1
Spondyloarthritis (SpA, earlier term ankylosing spondylitis) is though predominantly a disease affecting the axial and peripheral skeleton, its systemic involvement can be debilitating. There are several areas about this entity where still uncertainties exist. Although it's mainly a disease of adolescent men, women also do develop SpA. Cutaneous (psoriasis), gut (colitis), eyes (uveitis), and spine (sacroiliitis) are common extra-articular manifestations.
Current evidence points to a long delay in adequate assessment and appropriate diagnosis of individuals suffering from inflammatory back pain or other symptoms. This delay unfortunately is universal.
On the management front of SpAs, rapid advances have been made. With increasing usage of biological agents such as anti-tumor necrosis factor (TNF) and interleukin (IL)-16 inhibitors, the lifestyle of these patients has changed.
This annual supplement of Indian Journal of Rheumatology focuses on the newer insights to this disease. Expert authors have discussed recent advances in several areas, including pathogenesis, HLA B27, newer imaging tools for early diagnosis, and current treatment strategies, including biologics and biosimilars.
Malaviya in his chapter on the history of SpA brings to our notice several interesting facts. Jain and Moorthy have focused on pathogenesis of SpA and cytokine-mediated disease. Ahmed and Misra have delved on HLA B27, the genetic link in the evolution of SpA. Sham and Ravindran have discussed the classification criteria used in SpA research and its possible implications to clinical practice.
Magnetic resonance imaging (MRI) has transformed the way SpA is diagnosed by allowing early diagnosis of sacroiliitis. Chen and colleagues in their chapter have discussed MRI and other imaging modalities in SpA.
Pathak and Gaffney have discussed spectrum of diseases under SpAs including colitis, Crohn's disease, uveitis, and psoriasis. Chauhan has discussed how the eyes are the gateway to systemic manifestations. Hackett and Coates have highlighted the shared immunopathological link between psoriasis and SpAs. Hafis and Agarwal have discussed inflammatory bowel diseases-related SpAs and elucidated how it can be screened in patients with inflammatory back pain.
Recent insights into the immune mediators of the inflammatory cascade have resulted in targeted treatment strategies in patients with SpAs. Sulfasalazine has been used for several decades in this disease, and Shankar and Hegde have discussed recent evidence on such DMARD treatments. Castillo-Gallego et al. have thrown more light on the “new kids on the block” – TNF blockers, IL-17 blockers, and IL-22 monoclonal antibodies in achieving effective disease control and remission in patients with SpAs.
We thank all the authors (please see page Siii and Siv) and reviewers (please see page S71) for their extremely valuable contributions to this supplement. We express our sincere gratitude to Prof. Vikas Agarwal, Editor-in-Chief, for inviting us to guest edit this supplement on SpAs.
We hope this supplement would benefit the readers by providing up-to-date developments in the field of SpA.
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Conflicts of interest
There are no conflicts of interest.