Spondyloarthritis

ZUSAMMENFASSUNG

Der Begriff Spondyloarthritis umfasst mehrere Krankheitsbilder, die sich in der Pathophysiologie und im klinischen Erscheinungsbild ähneln. Zu der Gruppe der Spondyloarthritiden werden die axiale Spondyloarthritis, die Psoriasisarthritis, die reaktive Arthritis, die chronisch entzündliche Darmerkrankung (CED)-assoziierte Spondyloarthritis und die undifferenzierte Spondyloarthritis gezählt. Die Auswahl von geeigneten Therapiestrategien mit hoher klinischer Effektstärke basiert stärker auf der Charakterisierung des klinischen Phänotyps und des Manifestationstyps als auf der indikationsbasierten Zuordnung. Durch die Heterogenität der Erkrankung und durch das Fehlen kontrollierter klinischer Studien, die als Endpunkt die Effektivität auf verschiedene Manifestationsformen vorsieht, ist die Evidenzlage für verschiedene Therapieprinzipien bezogen auf das Manifestationslevel niedrig. Dies beschränkt den In-Label-Einsatz verschiedener Wirkprinzipien. Hier besteht ein hoher Bedarf für die Potenzierung von Evidenz, damit effektive Therapien individualisiert im Patientenkollektiv eingesetzt werden können.

SUMMARY

The term “spondyloarthritis” encompasses several clinical indications that are similar in pathophysiology and clinical appearance. Spondyloarthritis includes axial spondyloarthritis, psoriatic arthritis, reactive arthritis, inflammatory bowel disease (IBD)-associated spondyloarthritis and undifferentiated spondyloarthritis. The selection of suitable therapy strategies with a high clinical effect size is based more on the characterization of the clinical phenotype and the manifestation type than on the indication-based assignment. Due to the heterogeneity of the diseases and the lack of controlled clinical studies, which envisage the effectiveness on various forms of manifestation as an endpoint, the evidence base for various therapeutic principles in relation to the level of manifestation is low. This limits the in-label use of various active principles. There is a high need here for the potentiation of evidence so that effective therapies can be used in an individualized way in this special patient cohort.

Schlüsselwörter

Axiale Spondyloarthritis - Psoriasisarthritis - reaktive Arthritis - Therapieempfehlungen - Klassifikation

Keywords

Axial spondyloarthritis - psoriatic arthritis - reactive arthritis - treatment recommendations - classification

Publication History

Article published online:
20 April 2021

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