Purpose of review: Spondyloarthritis (SpA) is a group of diverse interrelated inflammatory arthritides, which share multiple clinical features as well as common genetic predisposing factors. Ankylosing spondylitis (AS) is regarded as the most typical subtype. The purpose of this article is to review relevant studies conducted in Asia and other parts of the world, which may open a window to a better understanding of the epidemiology, clinical feature, diagnosis, and management of this condition.
Recent findings: The prevalence, clinical feature, diagnosis, and therapy of SpA and its correlation with HLA-B27 in Asia are generally similar to other parts of the world. NSAIDs form the cornerstone of the treatment for AS. The new treatment options with tumor necrosis factor (TNF)-α blocking agents seem a breakthrough for patients with SpA refractory to conventional treatment. Recent results showed that thalidomide was an effective, well tolerated, and economic option for refractory AS patients, especially in maintaining disease remission after etanercept or infliximab treatment was discontinued.
Summary: The similarities between spondyloarthritides in Asia and other parts of the world are major and the differences are minor. Because of the major socioeconomic burden and poor access to expensive means of treatment of SpA in Asia, the rheumatologists and physicians in Asia are working hard to look for effective but cheaper alternatively regimens for refractory SpA patients. Thalidomide may be a potentially effective option for patients who cannot afford biologicals in undeveloped areas.