Emerging research is set to reshape the understanding and treatment landscape of axial inflammation in psoriatic arthritis (PsA), with multiple clinical studies and classification initiatives underway, according to leading rheumatology expert Philip Mease, MD, from the University of Washington School of Medicine.
Recent findings indicate that axial inflammation, characterized by spine and sacroiliac joint involvement, affects approximately 40% of PsA patients. This significant prevalence has highlighted the need for more precise diagnostic and classification approaches.
"We know that in psoriatic arthritis, one of the clinical domains that can be present is axial inflammation, or spine inflammation. This is an immunologic process in the spine and sacroiliac joints," explains Dr. Mease, who serves as Clinical Professor at the University of Washington School of Medicine and Director of Rheumatology Research at Swedish Medical Center.
Advancing Treatment Options
Two notable clinical trials are currently generating anticipation in the rheumatology community. The phase 2 ARGO study (NCT05640245) is investigating sonelokimab, while the phase 4 STAR study (NCT04929210) is evaluating guselkumab specifically for axial PsA. These trials represent important steps forward in expanding therapeutic options for patients with axial involvement.
Developing Classification Criteria
A significant collaborative effort between the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and the Assessment of SpondyloArthritis International Society (ASAS) is addressing the challenges in defining axial PsA. The AXIS study aims to establish comprehensive classification criteria that consider multiple factors.
"Having a classification criteria is going to be important," Dr. Mease emphasizes, highlighting the complexity of diagnosis. "Do we do it based on clinical features? Do we base it on MRI findings or X-ray findings? What about the genotype of these patients?"
The development of these classification criteria represents a crucial step forward in standardizing disease assessment and improving treatment selection. Results from these ongoing studies are expected to be presented at upcoming medical conferences, potentially transforming the approach to axial PsA management.
