New treatment paradigms in spondyloarthritis

Curr Opin Rheumatol. 2018 Jan;30(1):79-86. doi: 10.1097/BOR.0000000000000457.


Purpose of review: The review presents the recent rapid expansion of therapeutical options in spondyloarthritis. Additionally, it focuses on the importance of additional questions raised by the growing therapeutic possibilities related to the optimal use of these drugs.

Recent findings: The emergence of new treatment options opens new avenues and opportunities for treating patients with nonresponse, contraindications, or intolerance for classic drugs. However, it becomes more relevant than ever to define not only drugs and treatment options but also treatment strategies. We address current literature and remaining questions on strategies such as early intervention, combination treatment, personalized medicine, and treat-to-target.

Summary: Not only the treatment as such, but also the treatment strategy is crucial to reveal the full therapeutic potential and benefit for patients. Whereas cautious but crucial steps have been taken in the last years to explore these aspects, related to timing and sequence of treatment (including combination treatments), stratified medicine approaches, and treat-to-target strategies, it is now time for full-scale investment in prospective strategy trials.

Publication types

  • Review

MeSH terms

  • Abatacept / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Psoriatic / drug therapy*
  • Dermatologic Agents / therapeutic use*
  • Humans
  • Spondylarthritis / drug therapy
  • Spondylarthropathies / drug therapy
  • Spondylitis, Ankylosing / drug therapy*
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Ustekinumab / therapeutic use


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Dermatologic Agents
  • Tumor Necrosis Factor-alpha
  • Thalidomide
  • Abatacept
  • ixekizumab
  • secukinumab
  • Ustekinumab
  • apremilast