Journal
JOINT BONE SPINE
Volume 91, Issue 1, Pages -Publisher
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.jbspin.2023.105625
Keywords
Axial spondyloarthritis; Psoriatic arthritis; Axial psoriatic arthritis; Ankylosing spondylitis; Ustekinumab; Guselkumab; IL-17 inhibitors; IL-23/IL-17 axis
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Axial psoriatic arthritis (axPsA) has unique clinical and radiographic features compared to axial spondyloarthritis (axSpA). IL-23 inhibitors may be effective in treating axPsA, but further clinical trials are needed. Developing classification criteria and assessment tools for axPsA is also necessary.
Axial psoriatic arthritis (axPsA) has considerable overlap with axial spondyloarthritis (axSpA) but has some unique features that sometimes preclude classification into axSpA. It has some clinical and radiographic differences compared to axSpA. Imaging typically shows asymmetric syndesmophytes, mainly in the cervical spine, with less frequent sacroiliitis. It more commonly presents later in life and is associated with less severe inflammatory back pain than axSpA. The interleukin (IL) IL-23/IL-17 axis is central to the pathogenesis of both diseases. However, the response to therapies targeting these cytokines has been different. IL-23 inhibitors are ineffective in axSpA but may be effective in psoriatic arthritis (PsA). Recent post hoc analyses of clinical trial data with IL-23 inhibitors in PsA have raised the possibility of their efficacy in axPsA and need evaluation in future clinical trials. Moreover, there is a need for classification criteria for axPsA and better tools to assess therapeutic response. (c) 2023 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
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