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Therapies of Early, Advanced, and Late Onset Forms of Axial Spondyloarthritis, and the Need for Treat to Target Strategies

  • Spondyloarthritis (M Khan, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This study aims to provide an update on current status of pharmacological therapies in early and advanced stages of axial spondyloarthritis (axSpA), as well as its late onset forms, and to discuss the need for treat to target strategies in this entity.

Recent Findings

Efficacy of TNF inhibitors has been assessed in randomized controlled trials in axSpA, which included patients who had non-radiographic axSpA according to the ASAS classification criteria. The role of IL17/23 pathway as a therapeutic target in ankylosing spondylitis (AS) has been the focus of phase III studies of secukinumab (named MEASURE 1 and MEASURE 2) and a proof-of-concept study of ustekinumab. Potential efficacy of novel small molecules such as apremilast and tofacitinib has been explored in recent phase II trials.

Summary

All the trials of TNF inhibitors in non-radiographic axSpA have achieved their primary endpoints, which resulted in their approval for this indication in Europe, but not in USA. The phase III trials of secukinumab have demonstrated significant therapeutic benefit as compared to placebo, resulting in its approval as the first non-TNF biologic for the treatment of AS, both by the US Food and Drug Administration and the European Medicines Agency.

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Correspondence to Nurullah Akkoc.

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Dr. Padula and Dr. Can declare that they have no conflicts of interest.

Dr. D’Angelo reports personal fees from Abbvie, personal fees from Bristol–Myers Squibb, personal fees from MSD, personal fees from Pfizer, personal fees from Roche, and personal fees from UCB, outside the submitted work.

Dr. Olivieri reports personal fees from Abbvie, personal fees from Bristol–Myers Squibb, personal fees from MSD, personal fees from Pfizer, personal fees from Roche, and personal fees from UCB, outside the submitted work.

Dr. Akkoç reports grants, personal fees and non-financial support from Pfizer, personal fees and non-financial support from Abbvie, grants, personal fees and non-financial support from MSD, grants and personal fees from UCB, personal fees from Novartis, non-financial support from Roche, personal fees and non-financial support from BMS, and personal fees from Amgen, outside the submitted work.

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Akkoc, N., Can, G., D’Angelo, S. et al. Therapies of Early, Advanced, and Late Onset Forms of Axial Spondyloarthritis, and the Need for Treat to Target Strategies. Curr Rheumatol Rep 19, 8 (2017). https://doi.org/10.1007/s11926-017-0633-0

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