Spondyloarthritis: How far are we from precision medicine?

Abstract

Spondyloarthritis (SpA) is a family of heterogenous diseases consisting of different phenotypes. The exact disease mechanism remains unclear but evidence shows the complex pathophysiology with interplay between genome, microbiome, and immunome. Biologic DMARDs have markedly improved patients' disease control and quality of life. However, treatment response varies among patients. There is a growing need to identify biomarkers for the diagnosis, prognosis, prevention, and treatment of SpA. Genomic studies have been the research focus in the past two decades and have identified important genes involved in SpA. In recent years, emerging evidence supports the link between gut and joint inflammation in SpA, in which the role of gut microbiome in SpA is of great interest. Herein, potential genetic and gut microbial biomarkers for predicting treatment response are discussed. Novel strategies targeting dysbiosis in SpA are also summarized. These results represent a significant step toward precision medicine for patients with SpA.

Clinical and imaging findings in enteropathic spondyloarthritis with special emphasize in diagnostic delay: a cross-sectional study

“… 1 SpA primarily affect entheses, small and large joints, and the axial skeleton joints. 2 The Assessment of SpondyloArthritis International Society (ASAS) classification criteria for SpA distinguishes two clinical forms based on the predominant manifestation of the disease: axial SpA (axSpA) and peripheral SpA. 3 In accordance with ASAS criteria, axSpA is characterized by chronic back pain and encompasses radiographic axSpA (r-axSpA) as well as non-radiographic axSpA (nr-axSpA), which can lead to structural damage and disability.…”