The classification of spondyloarthritis remains an evolving topic. While there is general agreement on the current ASAS classification of axSpA, there is remaining uncertainty on whether clinical differences among patients meeting these criteria may have relevance for prognosis, disease progression, and response to therapy. Nonradiographic axSpA has emerged as one subclassification, though it appears to be part of the spectrum of axSpA rather than an entity in itself. As such, it currently seems to have more relevance as a regulatory construct than a disease definition. Other aspects of disease, such as gender, duration, and inflammatory burden, some of which may differ in those patients with nr-axSpA, appear to be more relevant to clinical course and treatment response. As these other demographic elements are better understood, particularly with respect to their impact on therapy, the concept of nr-axSpA will almost certainly become less important.
AS: Ankylosing spondylitis; ASAS: Assessment of SpondyloArthritis International Society; ASDAS: Ankylosing Spondylitis Disease Activity Score; axSpA: Axial spondyloarthritis; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; BASFI: Bath Ankylosing Spondylitis Functional Index; CRP: C-reactive protein; DESIR: Devenir des Spondylarthropathies Indifférenciées Récentes; DMARD: Disease-modifying antireheumatic drug; ESSG: European Spondyloarthropathy Study Group; GESPIC: German Spondyloarthritis Inception Cohort; HLA: Human leukocyte antigen; HRQOL: Health-related quality of life; hsCRP: High-sensitivity C-reactive protein; IL: Interleukin; mNY: Modified New York; MRI: Magnetic resonance imaging; NHANES: National Health and Nutrition Examination Survey; nr-axSpA: Nonradiographic axial spondyloarthritis; NSAID: Nonsteroidal anti-inflammatory drug; r-axSpA: Radiographic axial spondyloarthritis; SpA: Spondyloarthritis; TNF: Tumor necrosis factor
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Arthritis Res Ther. 2017;19(286) © 2017 BioMed Central, Ltd.
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