Navarro-Compán Victoria, Ermann Joerg, Poddubnyy Denis
University Hospital La Paz and IdiPaz, Madrid, Spain.
Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Ther Adv Musculoskelet Dis. 2022 Jul 22;14:1759720X221111611. doi: 10.1177/1759720X221111611. eCollection 2022.
The last two decades have seen major developments in the field of spondyloarthritis (SpA), but there are still important unmet needs to address. In the future, we envisage important advances in the diagnosis and treatment of SpA. In the diagnosis of SpA, the use of online and social media tools will increase awareness of the disease and facilitate the referral of patients to rheumatology clinics. In addition, more specific diagnostic tests will be available, especially advanced imaging methods and new biomarkers. This will allow most patients to be diagnosed at an early stage of the disease. In the treatment of SpA, an increasing number of novel treatment targets can be expected, most of which will be directed against intracellular enzymes. We hope to see more strategy trials shaping treatment pathways in SpA and accommodating principals of precision medicine. Approved treatment options will be available for both axial and peripheral SpA. We also hope to intervene not only at the inflammation level but also at the level of underlying immunological processes that might be associated with a higher probability of long-standing remission if not a cure. Finally, artificial intelligence techniques will allow for the analysis of large-scale data to answer relevant research questions for the diagnosis and management of patients with SpA.
过去二十年里，脊柱关节炎（SpA）领域取得了重大进展，但仍有一些重要的未满足需求有待解决。未来，我们预计SpA的诊断和治疗将取得重要进展。在SpA的诊断方面，在线和社交媒体工具的使用将提高对该疾病的认识，并促进患者转诊至风湿病诊所。此外，将有更多特异性诊断测试可供使用，尤其是先进的成像方法和新的生物标志物。这将使大多数患者能够在疾病早期得到诊断。在SpA的治疗方面，预计会有越来越多的新型治疗靶点，其中大多数将针对细胞内酶。我们希望看到更多的策略性试验来塑造SpA的治疗路径，并适应精准医学原则。对于轴向型和外周型SpA都将有获批的治疗选择。我们还希望不仅在炎症水平进行干预，而且在潜在免疫过程水平进行干预，如果不能治愈，这可能与长期缓解的更高概率相关。最后，人工智能技术将能够分析大规模数据，以回答有关SpA患者诊断和管理的相关研究问题。
