Current Trends and Advances in Spondyloarthritis

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 2308

Special Issue Editor


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Guest Editor
Rheumatology Department, USL Tuscany Center, San Giovanni di Dio Hospital, Via di Torre Galli 3, 50143 Florence, Italy
Interests: connective disease; vasculitis; rheumatoid arthritis; spondyloarhtitis; rheumatoid arthritis; ultrasound; rare disease
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Special Issue Information

Dear Colleagues,

We are pleased to announce the launch of a new Special Issue entitled “Current Trends and Advances in Spondyloarthritis” (JPM).

Spondyloarthritides (SpA) represent a heterogeneous group of chronic inflammatory diseases, characterized by axial, enthesis and peripheral involvement that may occur together with extra-articular manifestations, such as psoriasis, inflammatory bowel disease, uveitis, and systemic syndromes (e.g., cardiovascular and lung involvement, osteoporosis, psychiatric and sleep disorders).

In recent years, the growing knowledge of pathophysiology, genetic predisposition, classification criteria, imaging and treatment has profoundly increased the quality of the research on SpA, even if the complexity and variety of clinical manifestations of the disease still cause diagnostic and therapeutic delay.

The research approach based on new classification criteria, even ameliorated, still risks to decontextualize and undersize possible sexes, racial and clinical bias, as consequence of a complex skein of factors.

Firstly, even if substantial evidence exists that familiarity, HLA*B27 and *C06 might have a role in genetic predisposition in SpA patients, the underlying molecular basis of this susceptibility and the role of other haplotypes and gene polymorphisms are still under debate.

Furthermore, the paucity of new effective serum biomarkers, the presence of subclinical underlying disease shown by MRI and ultrasound, and the comorbidity of fibromyalgia and depressive mood often confound the definitive choice for diagnosis, activity measure, and treatments.

Thus, the increased awareness of the early stage of the disease and knowledge of clinical progression in late stages might contribute to revolutionize the treat-to-target strategy with more tailored and multifactorial treatments and the achievement of a drug-free remission in SpA patients.

The aim of this Special Issue is to provide a broad update on the pathogenetic, diagnostic and clinical aspects of SpA that might ameliorate the knowledge from bench to bedside of some still enigmatic aspects of disease.

We are soliciting original articles, reviews, systematic reviews and meta-analyses, as well as case series related to future challenges in the field of SpA.

Dr. Francesca Bandinelli
Guest Editor

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Keywords

  • spondyloarthritis
  • ultrasound
  • MRI
  • HLA
  • gene
  • biomarkers
  • classification

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Published Papers (2 papers)

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Research

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14 pages, 1247 KiB  
Article
Retention Rate of Ixekizumab in Psoriatic Arthritis: A Real-World Study
by Elisa Bellis, Piero Ruscitti, Denise Donzella, Gloria Crepaldi, Valeria Data, Marinella Gammino, Mariele Gatto, Valeria Guardo, Claudia Lomater, Elena Marucco, Marta Saracco and Annamaria Iagnocco
J. Pers. Med. 2024, 14(7), 716; https://doi.org/10.3390/jpm14070716 - 3 Jul 2024
Cited by 1 | Viewed by 913
Abstract
We aimed to examine the drug retention rate (DRR) of the interleukin-17 inhibitor ixekizumab in a real-world monocentric cohort of psoriatic arthritis (PsA) patients and to assess the predictors of drug discontinuation. Consecutive PsA patients who underwent treatment with ixekizumab from October 2019 [...] Read more.
We aimed to examine the drug retention rate (DRR) of the interleukin-17 inhibitor ixekizumab in a real-world monocentric cohort of psoriatic arthritis (PsA) patients and to assess the predictors of drug discontinuation. Consecutive PsA patients who underwent treatment with ixekizumab from October 2019 to February 2023 were enrolled in this observational, retrospective, monocentric study. Clinical records were assessed at baseline and throughout the follow-up period. We collected sociodemographic data, smoking habits, body mass index, the presence of Human Leukocyte Antigen B27, comorbidities, disease involvement and duration, previous therapy, discontinuation of ixekizumab, reasons for discontinuation, and adverse events (AEs). DRR was evaluated as time to drug discontinuation and assessed through Kaplan–Meier curves. Baseline factors predicting drug discontinuation were investigated through logistic regression models. Eighty PsA patients were included in this study. Ixekizumab was administered at a dose of 160 mg by subcutaneous injection at baseline, followed by 80 mg every four weeks thereafter. Ixekizumab had a 38-month-cumulative DRR of 43.8%, accounting for both inefficacy and AEs. When considering only inefficacy, the DRR was 62.6%. Comorbidities (p = 0.665), obesity (p = 0.665), smoking (p = 0.884), disease duration ≤ 2 years (p = 0.071), axial (p = 0.131) and skin involvement (p = 0.460), and previous therapies, including conventional synthetic (p = 0.504) and biological (p = 0.474) Disease-Modifying Antirheumatic Drugs (bDMARDs), as well as the number of previous bDMARDs or targeted synthetic Disease-Modifying Antirheumatic Drugs (tsDMARDs), did not significantly affect the DRR (p = 0.349). Multivariate analysis found no independent predictors of drug discontinuation. The most frequent AEs leading to discontinuation were skin reactions; no severe infections were observed. In our real-world study, comorbidities, disease duration, and previous therapies did not affect the DRR of ixekizumab. Ixekizumab had a favorable safety profile, with no severe AEs observed. Full article
(This article belongs to the Special Issue Current Trends and Advances in Spondyloarthritis)
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Review

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27 pages, 11277 KiB  
Review
Imaging of Sacroiliac Pain: The Current State-of-the-Art
by Marina Carotti, Luca Ceccarelli, Anna Claudia Poliseno, Francesca Ribichini, Francesca Bandinelli, Enrico Scarano, Sonia Farah, Marco Di Carlo, Andrea Giovagnoni and Fausto Salaffi
J. Pers. Med. 2024, 14(8), 873; https://doi.org/10.3390/jpm14080873 - 17 Aug 2024
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Abstract
Pain in the sacroiliac (SI) region is a common clinical manifestation, often caused by diseases involving the SI joints. This is typically due to inflammation or degenerative changes, while infections or cancer are less frequent causes. The SI joint is challenging to image [...] Read more.
Pain in the sacroiliac (SI) region is a common clinical manifestation, often caused by diseases involving the SI joints. This is typically due to inflammation or degenerative changes, while infections or cancer are less frequent causes. The SI joint is challenging to image accurately because of its distinct anatomical characteristics. For an accurate diagnosis, conventional radiography often needs to be supplemented with more precise methods such as magnetic resonance imaging (MRI) or computed tomography (CT). Sacroiliitis, a common presenting feature of axial spondyloarthritis (axial SpA), manifests as bone marrow edema, erosions, sclerosis, and joint space narrowing. Septic sacroiliitis and repetitive stress injuries in sports can also cause changes resembling inflammatory sacroiliitis. Other conditions, such as osteitis condensans ilii (OCI), can mimic the radiologic characteristics of sacroiliitis. Inflammatory lesions are diagnosed by concurrent erosions, hyperostosis, and ankylosis. Ligament ossifications or mechanical stress can also result in arthritic disorders. Determining the exact diagnosis can be aided by the distribution of the lesions. Inflammatory lesions can affect any part of the articulation, including the inferior and posterior portions. Mechanical lesions, such as those seen in OCI, often occur in the anterior middle region of the joint. In cases of idiopathic skeletal hyperostosis, ligament ossification is found at the joint borders. This pictorial essay describes common SI joint problems, illustrated with multimodal imaging data. We, also, discuss strategies for selecting the best imaging modalities, along with imaging pitfalls, key points, and approaches for treating patients with suspected inflammatory back pain. Full article
(This article belongs to the Special Issue Current Trends and Advances in Spondyloarthritis)
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