Potential experimental therapies are promising, including IL17 blockers and IL23 blockers. Current effective therapies to control SpA disease activity are available, including exercise and physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying antirheumatic drugs (DMARDs) such as sulfasalazine, and biological agents, mainly TNF blockers. Treatment goals for SpA are maintenance of physical function, disease activity, and prevention of radiographic progression to ankylosis. However, there are still many debates about the scope of this new term, nr-ax SpA, including the definition, disease natural course, clinical diagnosis, and management strategies. A new disease term, nonradiographic axial SpA (nr-ax SpA), was thus created to describe patients who fulfilled the 2009 ASAS criteria for axial SpA but not the 1984 modified New York criteria for AS. These classification criteria aimed to standardize definition of this diseases spectrum for clinical researches and emphasized early detection of SpA by usage of magnetic resonance imaging (MRI) in sacroiliac joints and human leukocyte antigen- (HLA-) B27 in diagnosis of SpA. The Assessment in Spondyloarthritis International Society (ASAS), an international task force, had generated new ASAS criteria for axial and peripheral SpA by predominant pattern of clinical manifestations in 20. AS: ankylosing spondylitis nr-ax SpA: nonradiographic axial spondyloarthritis PsA: psoriatic arthritis ReA: reactive arthritis IBD: inflammatory bowel diseases.

With different genetic backgrounds and environmental factors, patients may have different phenotype, such as ankylosing spondylitis, psoriatic arthritis, or inflammatory bowel diseases. After being triggered by environmental factors, such as infection or mechanical trauma, the immune dysregulation and inflammation occurred in enthesis through Th17 and Th1 immune reaction. Patients of SpA need a genetic background, such as HLA-B27, B60, ERAP-1, and IL23R. Development and pathogenesis of spondyloarthritis (SpA).

Spine diseases