Spondyloarthritis phenotypes: rationale of evaluation in context of personified medicine

Abstract

The article contents the analysis of different clinical phenotypes in the most common spondyloarthritis (SpA): ankylosing spondylitis (AS), axial spondylarthritis (axSpA) and psoriatic arthritis (PsA). SpA polymorphism has been discussed on the basis of multiple clinical presentations, structural lesions, radiological, immunological and genetic characteristics. Role of pro-inflammatory agents especially IL-17 in structural progression has been pointed out. Recent data regarding the link between HLA-B27 antigen, gender and age specificity and different clinical manifestation of SpA are presented. Current algorithms for SpA management based on evidence of efficacy sDMARD and/or biologics in separate phenotypes of SpA as well as resistance to DMARD are highlighted. Authors have concluded that meticulous analysis of SpA manifestation and patient’s individual profile is critical in rational SpA management according to personified medicine strategy.