Do we need new therapies in spondyloarthritis?
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Do we need new therapies in spondyloarthritis?
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About this listen
This episode of RheumaCast explores why many individuals with axial spondyloarthritis (axSpA) fail to achieve remission, despite access to advanced therapies. The discussion centers on two key factors often overlooked in daily practice: diagnostic inaccuracy and the presence of non-inflammatory pain mechanisms such as nociplastic and neuropathic pain.
While a small group of patients presents with true treatment-refractory axSpA—characterized by persistent inflammation despite multiple advanced therapies—most cases of apparent non-response are explained by symptoms not driven by inflammation. These require different management strategies, including psychological support, structured exercise, and targeted pharmacological approaches.
The episode also addresses emerging therapeutic concepts, including dual-targeted strategies, modulation of the HLA-B27 immunopeptidome, and novel immune targets. Making remission a reality for all patients will depend on both better use of existing treatments and the development of new ones.
This episode is based on the publication: Poddubnyy D, et al. EULAR Rheumatol Open 2025;1:484–487 and developed with NotebookLM.