Current management approaches for the treatment of spondyloarthritis (SpA) are imprecise and depend largely on clinical assessment. A more personalized approach, which takes into account an individual patient's variation in genes, proteins, environment, and lifestyle, is beginning to receive attention although, to date, there are only few predictors of response to a given treatment. Spondyloarthritis are a group of rheumatic diseases with high clinical heterogeneity, sometimes accompanied by psoriasis and enthesitis, iritis, and inflammatory bowel disease. In order to select the optimal treatment for each individual patient amongst the multitude of therapeutic options, it is becoming increasingly important to group patients, based on clinical characteristics and assisted by multi-omics approaches (genome, epigenome, transcriptome, microbiome).
To date, drugs that block TNF, IL17 or IL12 / 23 are used for the treatment of SpA. However, apart from data on the superiority of some of these over others on skin psoriasis, the response on the other component is comparable for all molecules. This translates into an empirical choice by the rheumatologist with a high probability of therapeutic failure. Here, this Research Topic aims to:
- identify potential clinical, genetic and biochemical factors that can guide clinicians in choosing the best drug for that type of patient
- evaluate the success of therapeutic strategies in relation to patient characteristics (e.g. step-up and step-down strategies, concomitant treatment or not)
- explore the potential of non-DMARD therapeutic approaches such as microbiome-targeted therapy
The aim is to identify patient characteristics (whether clinical, genetic, enzymatic, cytokine or environmental) such as to allow a differentiation of response to the various biological drugs or treatment regimens in SpA:
- efficacy of the different bDMARDs in the various clinical patterns of disease
biomarkers indicative for treatment response patterns
- whether genetic profiling will help in choosing the right drug for the right patient?
- difference in efficacy between TNF-I and anti IL-I in SpA
- role of comorbidities in clinical response to bDMARDs
- different treatment strategies in real life disease subsets (step-up vs step-down, combination therapy)
- potential of microbiome-targeted therapies
Current management approaches for the treatment of spondyloarthritis (SpA) are imprecise and depend largely on clinical assessment. A more personalized approach, which takes into account an individual patient's variation in genes, proteins, environment, and lifestyle, is beginning to receive attention although, to date, there are only few predictors of response to a given treatment. Spondyloarthritis are a group of rheumatic diseases with high clinical heterogeneity, sometimes accompanied by psoriasis and enthesitis, iritis, and inflammatory bowel disease. In order to select the optimal treatment for each individual patient amongst the multitude of therapeutic options, it is becoming increasingly important to group patients, based on clinical characteristics and assisted by multi-omics approaches (genome, epigenome, transcriptome, microbiome).
To date, drugs that block TNF, IL17 or IL12 / 23 are used for the treatment of SpA. However, apart from data on the superiority of some of these over others on skin psoriasis, the response on the other component is comparable for all molecules. This translates into an empirical choice by the rheumatologist with a high probability of therapeutic failure. Here, this Research Topic aims to:
- identify potential clinical, genetic and biochemical factors that can guide clinicians in choosing the best drug for that type of patient
- evaluate the success of therapeutic strategies in relation to patient characteristics (e.g. step-up and step-down strategies, concomitant treatment or not)
- explore the potential of non-DMARD therapeutic approaches such as microbiome-targeted therapy
The aim is to identify patient characteristics (whether clinical, genetic, enzymatic, cytokine or environmental) such as to allow a differentiation of response to the various biological drugs or treatment regimens in SpA:
- efficacy of the different bDMARDs in the various clinical patterns of disease
biomarkers indicative for treatment response patterns
- whether genetic profiling will help in choosing the right drug for the right patient?
- difference in efficacy between TNF-I and anti IL-I in SpA
- role of comorbidities in clinical response to bDMARDs
- different treatment strategies in real life disease subsets (step-up vs step-down, combination therapy)
- potential of microbiome-targeted therapies