Abstract
Axial spondyloarthritis (axSpA) is divided into radiographic ankylosing spondylitis and non-radiographic axial spondyloarthritis according to the presence of radiological sacroiliitis. Both groups are similar but have differences.
Non-radiographic axSpA affects more women than men, has the same clinical severity as radiographic, but usually lower CRP ASAS (Assessment of SpondyloArthritis International Society) criteria have been proposed for the diagnosis of non-radiographic axSpA, which are classification, but can also be used as diagnostic tool in the hands of an experienced rheumatologist. The basic problem is the correct evaluation of the sacroiliac joints on magnetic resonance (MR) examination.
The X-ray progression of non-radiographic SpA to radiographic is estimated at 12% within two years. Based on successful randomized controlled trials, etanercept, adalimumab, certolizumab and golimumab have been approved for the treatment of non-radiographic axSpA.
A study with secukinumab was recently completed, and this biologic is expected to gain this indication this year as well.