Update on Treatment of Spondyloarthropathy

There’s a group of arthritic conditions with a genetic link called the spondyloarthropathies (SpA). SpA includes ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis, and enteropathic arthritis.

In this article, rheumatologists from the Albert Einstein Medical Center in Philadelphia give an update on the latest treatment for SpA. A review of each condition is included.

History, cause, and symptoms are presented for each disease. Specific clinical tests and imaging studies are also provided. Lab studies aren’t usually diagnostic. The SED rate and C-reactive protein (CRP) levels are often elevated. But these are just indicators of inflammation and don’t tell the doctor what exactly is wrong.

Early treatment of SpA is usually with medications to relieve symptoms. New biologic agents such as the TNF-alpha-antagonists have made the management of these diseases much easier. Other drugs such as nonsteroidal antiinflammatories (NSAIDs) and disease modifying antirheumatic drugs (DMARDs) are also helpful.

Physical therapy and exercise remain important parts of the treatment program. Sometimes steroid injections are used for single joints with persistent painful swelling. There’s no known cure for SpA. Once the diagnosis is made, treatment is a matter of managing the symptoms and improving function.