New Treatments and Targets for Axial Spondyloarthritis: A Personalized Approach to Improve Outcomes

Ankylosing spondylitis (AS) is an immune-mediated chronic inflammatory disease that typically affects the sacroiliac (SI) joints. Patients with AS suffer from debilitating pain and joint fusion that severely limits their mobility and functional capacity. AS is a form of axial spondyloarthritis (axSpA), in which SI structural damage is visible on X-rays; the other form is non-radiographic axSpA, in which structural damage has not occurred.

The goals of treatment are to minimize symptoms, maintain spinal flexibility and normal posture, reduce functional limitations, maintain work ability, and prevent the development of disease complications. Tumor necrosis factor alpha (TNF-α) inhibitors are frontline therapy. However, there are important differences in efficacy among available TNF-α blockers in AS. Newer approved therapies target interleukins (i.e. IL-17A), but physicians are less familiar with these therapies (compared to TNF-α inhibitors) and may have safety concerns.

This educational activity will focus on strategies to improve rheumatologists’ abilities to practice a treat-to-target approach to patient management.

Educational Objectives - At the conclusion of this activity, participants should be able to:

- Recognize the benefits of early diagnosis and treatment of AS

- Describe strategies to speed diagnosis and determine disease classification

- Apply current evidence regarding the efficacy and safety of traditional and new biologics to develop personalized management goals and plans based on a “treat-to-target” approach for patients with AS

- Describe strategies for implementation of quality improvements in clinical rheumatology practice