Healio Rheumatology, September 2017
Clinicians treating patients with spondyloarthropathies are required to walk many tightropes. One is the prevention of infections while treating patients with immunosuppressive drugs. Another is determining where clinical manifestations of spondyloarthritis end and the adverse event profile of the medication begins. Another is deciding when mainstay therapies, like tumor necrosis factor inhibitors, are working and when to move on to an agent with a novel or different target. The backdrop of all of this is little is known about the genetic factors that predispose patients to these diseases. In addition, the research community is beginning to compile metrics for patients to quantify and adequately express opinions on disease development, pain management and palliative care.
For Pedro M. Machado, MD, PhD, consultant rheumatologist at the Centre for Rheumatology and MRC Centre for Neuromuscular Diseases at University College London, understanding the basics is of critical importance. In a presentation at the EULAR Congress in June, he called spondyloarthritis “an umbrella term for a group of diseases that share genetic, clinical, immunological and imaging features, such as arthritis, enthesitis, dactylitis, chronic back pain, loss of spinal mobility, uveitis, psoriasis and inflammatory bowel disease.”