An update on serum biomarkers to assess axial spondyloarthritis and to guide treatment decision

Abstract

Axial spondyloarthritis (axSpA) is a group of debilitating, chronic, rheumatic conditions characterized by inflammation and new bone formation, mainly involving the spine and the sacroiliac joints. The lack of biomarkers in axSpA is well known. Despite significant treatment advances in recent years thanks to the introduction of drugs with a new mode of action, such as new biologic and targeted synthetic disease-modifying antirheumatic drugs, no relevant improvement in the identification of disease biomarkers has been achieved. Common parameters, such as erythrocyte sedimentation rate and C-reactive protein, which are routinely used to measure systemic inflammation, are the sole markers available to date and are not adequate to assess disease activity in all patients. The aim of this study is to review the most promising serum biomarkers that may help treatment decision in axSpA via a proper assessment of disease activity and identification of negative prognostic factors.

Keywords: ankylosing spondylitis; anti-drug antibodies; axial spondyloarthritis; biomarkers; disease activity; radiographic progression.

Figure 1.

Possible pathogenetic mechanisms of secondary inefficacy to TNFα treatment. ADAbs, anti-drug antibodies; TNFα, tumor necrosis factor α