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Spondyloarthritis   

Questions discussed in this category

Would you escalate treatment for a patient with Crohn disease with changes suggestive of chronic sacroiliitis on MRI but without bone marrow edema or effusion that suggests active inflammation?
2 Answers available
Would you transition a patient with axial spondyloarthritis to a biologic if their axial symptoms were controlled with an NSAID, but they also required a PPI to control dyspepsia/GERD caused by the NSAID?
1 Answer available
Do you utilize serial MRI imaging in patients with axial spondyloarthritis to ensure good disease control or do you rely on symptoms and physical exam to assess treatment response?
1 Answer available
In a patient with isolated HLA B27+ anterior uveitis, how long would you continue immunosuppressive therapy?
The patient has no extraocular features of a spondyloarthropathy and is on methotrexate. No active eye disease for past 1 year.
1 Answer available
What is your approach to differentiating tender spots (as in fibromyalgia) and enthesitis (as in axSpA)?
1 Answer available
How would you approach a patient with axial spondyloarthritis who develops new-onset proteinuria?
2 Answers available
How would you manage a patient with highly active ankylosing spondylitis, iritis and Crohn’s, controlled with weekly adalimumab with co-morbid IgG4RD and intolerance of azathioprine due to elevated LFTs?
IgG4 manifestations include autoimmune pancreatitis and periaortic soft tissue mass.
2 Answers available
Do you consider it safe to continue adalimumab for spondyloarthritis in a patient who develops localized melanoma if the adalimumab has worked well?
1 Answer available
How do you manage inflammatory back pain when X-rays and MRI show no evidence of sacroiliitis?
Is an MRI necessary to diagnose non-radiographic axial spondyloarthritis?
2 Answers available
How would you approach the management of HLA-B27-associated recurrent uveitis and inflammatory back pain with a recent history of melanoma?
4 Answers available
In a patient with a Factor V Leiden heterozygous mutation but no prior thrombosis, would you consider using a JAK inhibitor for the treatment of spondyloarthritis or rheumatoid arthritis if other options have been ineffective?
1 Answer available
Does the presence of facet joint effusions on lumbar spine MRI increase your suspicion for axial spondyloarthritis?
1 Answer available
Which biologics are you comfortable combining with vedolizumab for spondyloarthritis or psoriatic arthritis patients in the setting of well-controlled inflammatory bowel disease?
2 Answers available
In a patient with active spondylarthritis and uveitis who cannot take TNF inhibitors, what is your next agent of choice?
1 Answer available
In patients undergoing MRI evaluation for inflammatory back pain, how long do you recommend they hold NSAIDs prior to imaging?
3 Answers available
How do you approach the concept of spondyloarthritis disease activity "burning out" and no longer requiring immunosuppression?
Is there a certain disease duration or age beyond which you taper immunosuppressive treatments?
1 Answer available
How do you manage injection site reactions in patients on subcutaneous biologics such as TNF inhibitors?
In what cases do you discontinue the medication?
2 Answers available
Would you use TNF inhibitors in patients with features of SLE, but active peripheral and axial spondylarthritis?
Patient with sacroiliitis on imaging, failure of two NSAIDs.
2 Answers available
Do you use apremilast in combination with biologic DMARDs for psoriatic arthritis and/or psoriasis?
Are there ways to overcome barriers in insurance coverage of this combination of treatments?
2 Answers available
How would you manage a patient with stable axial spondyloarthritis who develops newly active IgA nephropathy?
Is there a role for immunosuppressive medications such as TNF inhibitors in the management of IgA nephropathy in this setting?
2 Answers available
Are there specific recreational activities or exercises you recommend patients with ankylosing spondylitis avoid?
1 Answer available
Would you feel comfortable combining MMF and an IL-17 blocker in a patient with both limited scleroderma and psoriatic arthritis?
2 Answers available
How would you approach the treatment of erosive inflammatory arthritis (RA or SpA) in a patient with multiple sclerosis on ocrelizumab who has failed csDMARD therapy?
2 Answers available
How do you typically treat aortitis associated with spondyloarthritis?
1 Answer available
Would you consider using a JAK inhibitor in combination with an IL 23 inhibitor in cases of severe psoriasis, psoriatic arthritis, or axial spondyloarthritis that is refractory to multiple biologic DMARDs?
2 Answers available
How do you treat celiac disease associated inflammatory arthritis refractory to gluten free diet?
1 Answer available
Does multi-level facet joint ankylosis without vertebral body ankylosis heighten your suspicion for axial spondyloarthritis, or can isolated facet joint ankylosis be explained by degenerative disease of the spine alone?
1 Answer available
What drug class would you use to treat active psoriasis and psoriatic arthritis with axial involvement in patients on immunosuppression for other indications (e.g., tacrolimus for a liver transplant)?
1 Answer available
How long would you recommend that a patient continues guselkumab prior to deciding that the therapy is not effective?
In contrast to TNF inhibitors for psoriatic arthritis, which seem to peak and maintain response percentages, the DISCOVER-2 Trial (McInnes et al., PMI...
4 Answers available
How do you interpret treatment response in the DISCOVER-2 Trial when patients were allowed to remain on up to 10mg of prednisone equivalent for disease control while on guselkumab?
In clinical practice continued steroid dependence is often seen as a reason to switch therapy and providers can be especially hesitant to use systemic...
3 Answers available
Where in the sequence of biologics would you consider guselkumab for patients with active psoriatic arthritis despite standard DMARD therapy?
Based on the results of the DISCOVER-2 Trial (McInnes et al., PMID 34719872), should guselkumab be used prior to anti-TNF therapy in these patients?
3 Answers available
What has been your experience using apremilast to treat mild to moderate psoriatic arthritis not controlled with NSAIDs?
1 Answer available
What disease activity measures do you find helpful in clinical practice for psoriatic arthritis/peripheral spondyloarthritis?
1 Answer available
What studies do you find helpful to determine if an axial spondyloarthritis patient presenting late in the disease course with significant irreversible joint damage may benefit from immunosuppression?
1 Answer available
What is your approach to a patient with incidental radiographic findings of sacroiliitis without clinical inflammatory back pain?
2 Answers available
Are there any specific circumstances when you would consider the use of immunosuppression for DISH?
There is some emerging evidence that there is an inflammatory component. 
1 Answer available
How do you approach screening for inflammatory bowel disease prior to starting IL-17 inhibitors?
1 Answer available
What do you use to treat uveitis refractory to conventional synthetic DMARDs and TNF inhibitors?
Are IL-17 or IL-23 inhibitors helpful?
5 Answers available
Are there any therapeutic options for cauda equina syndrome secondary to dural ectasia in end-stage ankylosing spondylitis?
1 Answer available
Do you image the spine in addition to the sacroiliac joints when you suspect axial spondyloarthritis?
Can axSpA affect the spine without affecting the sacroiliac joints?
1 Answer available
Do you recommend the use of contrast to identify sacroiliitis on MRI?
2 Answers available
What treatment options are available for patients with spondyloarthritis who develop biologic-induced psoriasis?
1 Answer available
Is there evidence that either ASDAS or BASDAI is superior for measuring clinical outcomes in axial spondyloarthritis?
1 Answer available
Would you use an IL-17 inhibitor for a psoriatic arthritis patient with inactive inflammatory bowel disease?
1 Answer available
What are specific treatment considerations for dactylitis- or enthesitis-predominant AxSpa/PsA?
1 Answer available
What are the benefits of sending HLA B27 genotype over HLA B27 antigen when evaluating for spondyloarthritis?
2 Answers available
What is the preferred DMARD in active spondyloarthropathy with psoriasis and sacroiliitis features in the setting of treated hepatitis C with negative viral load?
In patients refractory to NSAIDs and sulfasalazine 
1 Answer available
What are some strategies for radiographically differentiating between erosions secondary to erosive osteoarthritis versus psoriatic arthritis involving the DIP joints?
1 Answer available
How do you differentiate between axial psoriatic arthritis and axial spondylitis with psoriasis, and is it important to distinguish between these two conditions from a prognostic and treatment perspective?
1 Answer available
Is it okay to use COX-2 selective NSAIDs in patients with IBD-associated arthritis when the IBD is in remission?
1 Answer available
What do you try in patients with IBD-related spondyloarthritis with predominantly axial symptoms who are refractory to TNF inhibitors?
1 Answer available


Papers discussed in this category

Annals of the rheumatic diseases, 2017-08
Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study.
Lancet (London, England), 2018-12-01
Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomised, placebo-controlled, phase 2 trial.
Arthritis Rheumatol, 2019 Oct
2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.
Lancet, 2019 Nov 12
Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis (SELECT-AXIS 1): a multicentre, randomised, double-blind, placebo-controlled, phase 2/3 trial.
Cochrane Database Syst Rev, 2014 Oct 23
Tolerability of selective cyclooxygenase 2 inhibitors used for the treatment of rheumatological manifestations of inflammatory bowel disease.
Arthritis & rheumatology (Hoboken, N.J.), 2016-05
Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis.
Rheumatology (Oxford),
Is axial psoriatic arthritis distinct from ankylosing spondylitis with and without concomitant psoriasis?
Rheumatology (Oxford),
Axial disease in psoriatic arthritis.
Clin. Exp. Rheumatol., 2016 Dec 13
Clinical and genetic associations of radiographic sacroiliitis and its different patterns in psoriatic arthritis.
Lancet, 2015 Oct 01
Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial.
J Rheumatol Suppl,
GRAPPA 2018 Project Report.
Nat Rev Rheumatol,
Axial disease in psoriatic arthritis and ankylosing spondylitis: a critical comparison.
Rheumatology (Oxford),
Treatment guidelines in psoriatic arthritis.
Ann Rheum Dis, 2015 Dec 07
European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update.
J Med Imaging Radiat Oncol,
Gull-wing deformity: Osteoarthritis.
J Ultrason, 2016 Mar 29
Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features.
Ophthalmology, 2015-05
Efficacy and safety of intravenous secukinumab in noninfectious uveitis requiring steroid-sparing immunosuppressive therapy.
Retina,
LONG-TERM OUTCOMES OF RITUXIMAB THERAPY IN PATIENTS WITH NONINFECTIOUS POSTERIOR UVEITIS REFRACTORY TO CONVENTIONAL IMMUNOSUPPRESSIVE THERAPY.
Ophthalmic Res, 2018 Apr 10
Cyclophosphamide or Rituximab Treatment of Scleritis and Uveitis for Patients with Granulomatosis with Polyangiitis.
Dev Ophthalmol, 2012 Apr 17
Rituximab for noninfectious uveitis.
Arthritis Rheumatol, 2019 Aug 12
Long-Term Outcome of Ustekinumab Therapy for Behçet's Disease.
American journal of ophthalmology, 2017-11
Primary (Month-6) Outcomes of the STOP-Uveitis Study: Evaluating the Safety, Tolerability, and Efficacy of Tocilizumab in Patients With Noninfectious Uveitis.
Journal of spinal disorders, 2001-10
Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments.
Arthritis Rheum,
Dramatic efficacy of infliximab in cauda equina syndrome complicating ankylosing spondylitis.
Annals of the rheumatic diseases, 2017-04
International patient and physician consensus on a psoriatic arthritis core outcome set for clinical trials.
Arthritis Care Res (Hoboken), 2018 Aug
Value of the Routine Assessment of Patient Index Data 3 in Patients With Psoriatic Arthritis: Results From a Tight-Control Clinical Trial and an Observational Cohort.
Arthritis Care Res (Hoboken),
Measuring Outcomes in Psoriatic Arthritis.
Curr Rheumatol Rep,
Polymorphism of HLA-B27: 105 subtypes currently known.
Ann Rheum Dis, 2011 Jul 28
HLA-B27 positive patients differ from HLA-B27 negative patients in clinical presentation and imaging: results from the DESIR cohort of patients with recent onset axial spondyloarthritis.
Arthritis Rheumatol, 2019 Jan
Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis.
Ann Rheum Dis,
EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update.
J Rheumatol,
A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index.
Ann Rheum Dis, 2008 Jul 14
Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis.
Ann Rheum Dis, 2010 Nov 10
Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores.
Journal of psoriasis and psoriatic arthritis, 2019-04
TNF Inhibitor-Induced Psoriasis: Proposed Algorithm for Treatment and Management.
Front Pharmacol, 2019 Mar 26
Paradoxical Skin Reactions to Biologics in Patients With Rheumatologic Disorders.
Rheumatology (Oxford), 2013 Feb 16
Magnetic resonance imaging of the sacroiliac joints in the early detection of spondyloarthritis: no added value of gadolinium compared with short tau inversion recovery sequence.
Ann Rheum Dis, 2005 Jan 13
Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau inversion recovery (STIR) sequences.
Ann Rheum Dis, 2016 Jan 14
Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group.
Ann Rheum Dis, 2014 Jan 22
Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis?
Ann Rheum Dis, 2012 May 14
Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI study group.
Ann Rheum Dis, 2015 Aug 18
Patients with chronic back pain of short duration from the SPACE cohort: which MRI structural lesions in the sacroiliac joints and inflammatory and structural lesions in the spine are most specific for axial spondyloarthritis?
Arthritis Rheumatol, 2020 May
Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta-Analysis.
Annals of the rheumatic diseases, 2009-06
The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection.
Arthritis Care Res (Hoboken), 2019 Oct
2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.
Gut, 1999-04
Linkage of Crohn's disease to the major histocompatibility complex region is detected by multiple non-parametric analyses.
Gut, 2012-12
Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn's disease: unexpected results of a randomised, double-blind placebo-controlled trial.
Annals of the rheumatic diseases, 2019-04
Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials.
Ann Rheum Dis, 2014 Mar 21
The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study.
Current rheumatology reports, 2009-10
Diffuse idiopathic skeletal hyperostosis: differentiation from ankylosing spondylitis.
Radiology,
Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH).
Curr Rheumatol Rep, 2021 Jan 26
Diffuse Idiopathic Skeletal Hyperostosis (DISH) and a Possible Inflammatory Component.
Arthritis Care Res (Hoboken), 2019 Jan
Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis.
J Rheumatol, 2017 Dec 01
Short-term Repeat Magnetic Resonance Imaging Scans in Suspected Early Axial Spondyloarthritis Are Clinically Relevant Only in HLA-B27-positive Male Subjects.
Arthritis Rheumatol, 2019 Feb 06
Is it Useful to Repeat Magnetic Resonance Imaging of the Sacroiliac Joints After Three Months or One Year in the Diagnosis of Patients With Chronic Back Pain and Suspected Axial Spondyloarthritis?
Arthritis Rheum,
Ten years' experience with needle biopsy in the early diagnosis of sacroiliitis.
Arthritis Rheumatol, 2022 Feb 07
Long-Term Efficacy and Safety of Guselkumab, a Monoclonal Antibody Specific to the p19 Subunit of Interleukin-23, Through Two Years: Results From a Phase III, Randomized, Double-Blind, Placebo-Controlled Study Conducted in Biologic-Naive Patients With Active Psoriatic Arthritis.
Ann Rheum Dis, 2020 Dec 17
Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial.
Eur J Dermatol,
Use of anti-IL 17A for psoriasis is not necessarily contraindicated in organ transplantation patients.
Dermatol Ther, 2019 Apr 23
Treatment of severe psoriasis with ixekizumab in a liver transplant recipient with concomitant hepatitis B virus infection.
Cutis,
Brodalumab in an Organ Transplant Recipient With Psoriasis.
Ann Rheum Dis, 2022 May 24
MRI lesions of the spine in patients with axial spondyloarthritis: an update of lesion definitions and validation by the ASAS MRI working group.
Rheumatology (Oxford),
Facet joint ankylosis in r-axSpA: detection and 2-year progression on whole spine low-dose CT and comparison with syndesmophyte progression.
The Journal of rheumatology, 2012-01
Combination biologic treatment of refractory psoriasis and psoriatic arthritis.
JAAD Case Rep, 2019 Oct 10
Dual biologic therapy for recalcitrant psoriasis and psoriatic arthritis.
RMD Open, 2019
Predictors of remission in patients with non-radiographic axial spondyloarthritis receiving open-label adalimumab in the ABILITY-3 study.
Best practice & research. Clinical rheumatology, 2014 Nov 10
Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis.
Rheumatology (Oxford, England), 2022 Apr 11
Factors associated with remission at 5-year follow-up in recent-onset axial spondyloarthritis: results from the DESIR cohort.
Kidney Int Rep, 2020 Mar 16
Spondyloarthritis-Associated IgA Nephropathy.
Current rheumatology reviews, 2019
Combination Therapy of Apremilast and Biologic Agent as a Safe Option of Psoriatic Arthritis and Psoriasis.
Am J Clin Dermatol, 2022 Jun 23
Combination Therapy with Apremilast and Biologics for Psoriasis: A Systematic Review.
Arthritis Res Ther, 2005 Mar 01
Systemic lupus erythematosus induced by anti-tumour necrosis factor alpha therapy: a French national survey.
Arthritis Rheum, 2004 Oct
Safety and efficacy of tumor necrosis factor alpha blockade in systemic lupus erythematosus: an open-label study.
Lancet Gastroenterol Hepatol, 2023 Feb 01
Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): a randomised, double-blind, controlled, phase 2, proof-of-concept trial.
Dig Liver Dis, 2022 Aug 16
Efficacy and safety of combination targeted therapies in immune-mediated inflammatory disease: the COMBIO study.
RMD open, 2022 Nov
Biomarkers to predict risk of venous thromboembolism in patients with rheumatoid arthritis receiving tofacitinib or tumour necrosis factor inhibitors.
Annals of gastroenterology, 2023 May 25
Outcome of inflammatory bowel disease patients with prior malignancy.
Melanoma research, 2022 Aug 22
Melanoma risk during immunomodulating treatment.
Arthritis research & therapy, 2021 Jan 29
Structural changes in the sacroiliac joint on MRI and relationship to ASDAS inactive disease in axial spondyloarthritis: a 2-year study comparing treatment with etanercept in EMBARK to a contemporary control cohort in DESIR.

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