New evidence supports the efficacy and safety of TNFi (originators/biosimilars) and IL-17i in r-axSpA and nr-axSpA. This systematic literature review was conducted to inform the taskforce of the 2022 update of the ASAS-EULAR recommendations.

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ASAS-EULAR Recommendations for the Management of Axial Spondyloarthritis: 2022 Update

Ann Rheum Dis 2022; online ahead of print doi:10.1136/ard-2022-223296

Since the last update in 2016, more data have become available on existing treatment options for axSpA, and particularly on IL-17i. The increasing availability of more drugs and with different modes of action raises questions around their positioning in the treatment pathway. This review sought to update the 2016 recommendations with newly available evidence.

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Non-pharmacological interventions are important for any rheumatic disease, but especially axSpA, where they represent the cornerstone of treatment. The aim of this study was to produce a systematic literature review on efficacy and safety of non-pharmacological and non-biological pharmacological treatments was performed.

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August 2022

Bimekizumab is associated with sustained, long-term efficacy in r-axSpA patinets across three years of treatment. In coming to this conclusion, investigators sought to assess the long-term safety, tolerability, and efficacy of bimekizumab in active r-axSpA.

Secukinumab improves the burden of heel enthesitis as assessed by patient and physician reported outcomes in patients with active SpA refractory to standard treatment. In coming to this conclusion, the ACHILLES trial aimed to demonstrate the efficacy of secukinumab on Achilles’ tendon enthesitis in SpA patients.

June 2022

Maksymowych et al., assessed the effects of filgotinib on inflammatory and structural changes at various spinal locations, based on MRI measures in patients with active ankylosing spondylitis in the TORTUGA trial. Correlations between changes in the inflammation score and clinical outcomes were also evaluated.

Enthesitis is a hallmark feature of SpA, including PsA and axSpA, and is proposed as the primary lesion in spondyloarthropathies. This study aimed to investigate the imaging characteristics of heel enthesitis in SpA in a post hoc analysis using the HEMRIS in blinded and centrally read MRI data from the ACHILLES trial..

Maksymowych et al., evaluated the efficacy of Ixekizumab in patients with radiographic axial spondyloarthritis (r-axSpA) with and without objective measures of inflammation.

Maksymowych et al., carried out a post-hoc analysis to assess the effect of filgotinib on MRI measures of structural change in the SI joint in patients with active AS in the TORTUGA trial. This study evaluated lesions using SPARCC SSS definitions for erosion, backfill, fat metaplasia and ankylosis by two independent scoring readers.

Bruckmann et al carried out this observational, proof of concept study to analyse the effect anti-TNF-therapy (TNFi) on inflammatory, structural, and osteoblastic activity lesions in radiographic axial spondyloarthritis (r-axSpA).