Contemplate bone damage in patients with axSpA
Pathogenic processes leading to bone damage
In axSpA, the inflammatory processes and new bone formation take place in the entheses, axial skeleton, and peripheral joints via the cytokine pathways, which are only just starting to be understood.2 Data suggests that bone erosion and new bone formation in axSpA may occur simultaneously at different anatomical sites, with IL-17 playing a complex role in these immune-mediated processes.1
Addressing bone changes in axSpA
The underlying processes leading to bone damage in axSpA need to be understood and addressed in order to improve clinical outcomes for patients. The loss of existing bone and new bone formation are highly relevant to overall burden of disease, including clinical manifestations, disability, and long-term outcomes, such as spinal fracture.3
In addressing bone pathophysiology, it is important to focus on robust clinical measures of both bone loss in vertebrae and of the drivers of osteoproliferation. This will help achieve the ultimate goal of developing therapeutic approaches to reduce osteitis/erosion, bone turnover and osteoproliferation, and improve long-term skeletal outcomes.3
Explore the underlying pathologic processes leading to bone damage
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Immune dysregulation
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- McGonagle DG, McInnes IB, Kirkham BW, et al. The role of IL-17A in axial spondyloarthritis and psoriatic arthritis: recent advances and controversies. Ann Rheum Dis. 2019;78:1167–1178
- Groen SS, Sinkeviciute D, Bay-Jensen AC, et al. Exploring IL-17 in spondyloarthritis for development of novel treatments and biomarkers. Autoimmun Rev. 2021;20(3):102760. doi:10.1016/j.autrev.2021.102760
- Clunie G, Horwood N. Loss and gain of bone in spondyloarthritis: what drives these opposing clinical features? Ther Adv Musculoskelet Dis. 2020;12:1759720X20969260. doi:10.1177/1759720X20969260