Neerinckx Barbara, Lories Rik
aLaboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center bDivision of Rheumatology, Department of Development and Regeneration, University Hospital Leuven, KU Leuven, Leuven, Belgium.
Curr Opin Rheumatol. 2017 Jul;29(4):287-292. doi: 10.1097/BOR.0000000000000404.
To discuss different aspects of new bone formation in patients with spondyloarthritis based on emerging data from clinical trials, prospective cohort studies and translational laboratory investigations.
New bone formation potentially leading to ankylosis of the spine and sacroiliac joints remains an important concern for patients with axial spondyloarthritis. New therapeutic strategies, in particular targeting of interleukin-17, have emerged in addition to the antitumor necrosis factor drugs, but we still fail to fully understand the mechanisms of structural disease progression. A new paradigm is developing in which sustained and effective suppression of inflammation likely inhibits this structural disease progression. Biomechanical factors, in particular changes in bone microarchitecture in the vertebrae, and the need for core stability could provide a new framework to understand the relationship between bone remodeling and inflammation and to develop long-term strategies.
New bone formation leading to ankylosis remains a hallmark of axial spondyloarthritis and should be further investigated. The clinical data that progressively become available support the concept that effective and sustained therapy will be beneficial for the patients not only in short-term, but also in long-term outcomes.
基于临床试验、前瞻性队列研究和转化实验室研究的新数据，探讨脊柱关节炎患者新骨形成的不同方面。
对于轴性脊柱关节炎患者而言，新骨形成可能导致脊柱和骶髂关节融合仍然是一个重要问题。除了抗肿瘤坏死因子药物外，新的治疗策略，尤其是针对白细胞介素-17的策略已经出现，但我们仍未完全理解结构疾病进展的机制。一种新的模式正在形成，即持续有效地抑制炎症可能会抑制这种结构疾病的进展。生物力学因素，特别是椎骨骨微结构的变化以及对核心稳定性的需求，可能为理解骨重塑与炎症之间的关系以及制定长期策略提供一个新框架。
导致融合的新骨形成仍然是轴性脊柱关节炎的一个标志，应进一步研究。逐渐可得的临床数据支持这样一种观念，即有效且持续的治疗不仅对患者的短期，而且对长期预后都将有益。
