Therapeutic landscape
Over the past 10 years, the treatment landscape of SpA went through a substantial change, with an expansion of new therapies and new modes of action. Guidelines and recommendations have been developed to guide clinicians in their decision and enable the best outcome for their patients.
Therapeutic options for axSpA1,2
- Non-pharmacological treatment: Regular physical exercise and, if needed, physiotherapy represent an essential pillar in the management of axSpA.
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Targeted biological therapies:
- Tumor necrosis factor (TNF) inhibitors
- Interleukin (IL)-17 inhibitors
- Janus kinase (JAK) inhibitors
Therapeutic options for PsA3-4
- Non-pharmacological treatment: Physical therapy, smoking cessation, weight loss, exercise
- Conditionally: non-steroidal anti-inflammatory drugs (NSAIDs), topicals, intra-articular/oral glucocorticoids.
- Conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs)
- Targeted biological therapies:
- TNF inhibitors
- IL-12/23 and IL-23 inhibitors
- IL-17 inhibitors
- Targeted synthetic DMARDs:
- JAK inhibitors
- Phosphodiesterase 4 (PDE4) inhibitors
- Ramiro et al. (2023) Ann Rheum Dis 82(1):19-34
- Ward et al. (2019) Arthritis Care Res (Hoboken) 71(10):1285-1299.
- Gossec L et al. (2020) Ann Rheum Dis 79(6):700-712
- Coates et al. (2022) Nat Rev Rheumatol 18(8):465-479.
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