体軸性脊椎関節炎の治療： アップデート
Nat Rev Rheumatol. 18, 205–216 (2022) 2022 doi: 10.1038/s41584-022-00761-z
In this review Danve and Deodhar report an update on modern axSpa treatment. They found that in the past two decades substantial progress in the diagnosis and management of axSpA has been witnessed. Whilst ASAS classification criteria have enabled earlier diagnosis the increased availability of novel therapies, evolving drug safety data and novel clinical trials have allowed clinicians to rethink the placement and timing of drugs in disease management.
The review highlights multiple additional recommendations for the treatment of axSpa. Patients experiencing diminishing efficacy are recommended to switch to another bDMARD after 12 weeks in line with ACR-SAA-SPARTAN guidelines and it is also not recommended to utilise IL-17i therapy in patients with symptoms of IBD. Patients with axSpA should also be encouraged to do regular strengthening exercises. Multidisciplinary management of the comorbidities associated with axSpA should become an integral part of treatment.
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