Division of Rheumatology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Gladman-Krembil Psoriatic Disease Program, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada.
Expert Rev Clin Immunol. 2024 Nov;20(11):1381-1400. doi: 10.1080/1744666X.2024.2384705. Epub 2024 Jul 29.
There are several treatment controversies that have emerged in spondyloarthritis and psoriatic arthritis. These are related to the nature of the conditions as well as to the use of medications.
This review, which included a search of PubMed database as well as the references within the articles provides an overview of the nature of spondyloarthritis, controversy over the inclusion of psoriatic arthritis (PsA) as a peripheral spondyloarthritis, and a summary of current treatments for both PsA and axial spondyloarthritis (axSpA), with special emphasis on targeted therapy. The review highlights the differences in response to certain medications, particularly biologic therapy and summarizes the randomized controlled trials in psoriatic arthritis and axial spondyloarthritis providing data about the responses in table format.
There is a need for better outcome measures in axSpA. Currently, the measures are subjective. Imaging may be more appropriate but there is a need for research into the reliability and responsiveness of imaging techniques. In PsA, there may also be better response measures and research into the reliability and responsiveness of available measures is underway. There is also a need for novel therapies as well as biomarkers for response in both diseases.
强直性脊柱炎和银屑病关节炎存在多种治疗争议。这些争议与疾病的性质以及药物的使用有关。
本文检索了 PubMed 数据库以及文章中的参考文献，概述了强直性脊柱炎的性质、将银屑病关节炎（PsA）纳入外周型脊柱关节炎的争议，以及目前针对 PsA 和中轴型脊柱关节炎（axSpA）的治疗方法，特别强调了靶向治疗。综述强调了对某些药物反应的差异，特别是生物疗法，并总结了银屑病关节炎和中轴型脊柱关节炎的随机对照试验，以表格形式提供了数据。
在 axSpA 中需要更好的疗效评估指标。目前，这些指标是主观的。影像学可能更合适，但需要研究影像学技术的可靠性和响应性。在 PsA 中，可能也有更好的反应评估指标，正在进行对现有评估指标的可靠性和响应性的研究。这两种疾病也需要新的治疗方法和反应的生物标志物。
