Non-radiographic axial spondyloarthritis

Abstract

Non-radiographic axial spondyloarthritis (nr-axSpA) is a subgroup of axial spondyloarthritis (axSpA) without fulfilling the modified New York criteria of sacroiliac joint radiographs for ankylosing spondylitis (AS). AS and nr-axSpA share various demographic and clinical features and disease burden, although sex and objective inflammatory findings such as elevated serum C-reactive protein level are slightly different between AS and nr-axSpA. Recently, diagnostic guidance for nr-axSpA in Japan was proposed for epidemiological studies of a population with a low prevalence of HLA-B27 positivity and the use of molecular targeted agents suitable for the unique medical care system in Japan. A biological agent targeting interleukin-17 was approved for nr-axSpA by the Pharmaceutical and Medical Devices Agency (PMDA) in August 2020. Some other biological agents will be also available for Japanese patients with nr-axSpA in the near future.

Keywords:

• Axial spondyloarthritis
• diagnosis
• HLA-B27
• inflammatory back pain
• sacroiliitis

Acknowledgments

The development of the diagnostic guidance for nr-axSpA in Japan is a collaborative work by Research On Rare And Intractable Diseases, Health and Labour Sciences Research Grant: a Large-scale multi-institutional research committee aiming at an epidemiological survey of spondyloarthritis, creation of diagnostic criteria, and development of clinical guidelines. The authors thank ASCA Corporation for editing the manuscript, the fees of which were supported by the above grant.

Conflict of interest

HK has received consulting fees, speaking fees, and/or honoraria from AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eisai Co. Ltd., Eli Lilly Japan K.K., Gilead Sciences, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma, Novartis Pharma K.K., and Sanofi Pharma, and has received research grants from AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma, Novartis Pharma K.K. and Sanofi Pharma.

SK has received speaker’s fees from Mitsubishi Tanabe Pharma Corp., Bristol-Myers Squibb Company, AbbVie GK, Novartis Pharma K.K., Asahi Kasei Corp., Bristol-Myers Squibb Company, Eli Lilly Japan K.K., and Janssen Pharmaceutical K.K., and received consulting fees from Kyowa Kirin Co., Ltd.

NT received research grants and/or speaking fees from AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Ayumi Pharmaceutical, Bristol-Myers Squibb K.K., Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Janssen Pharmaceutical K.K., Mitsubishi-Tanabe Pharma, Novartis Pharma K.K., and Takeda Pharmaceutical Co., Ltd.

YK has received consulting fees, speaking fees, and/or honoraria from AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma, Novartis Pharma K.K., and Ono Pharmaceutical Co., Ltd., and has received research grants from AbbVie G.K., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma, and Ono Pharmaceutical Co., Ltd.

KT has received speaking fees from AbbVie G.K., Eisai Co. Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi-Tanabe Pharma, and Novartis Pharma K.K.

MY has no conflict of interest.

TT has received consultancy and speaker fees from AbbVie, Astellas, Bristol-Myers Squibb, Eisai, Eli Lilly and Company, Janssen, Kyowa Kirin, Mitsubishi-Tanabe, Novartis, and Pfizer.

Additional information

Funding

This work was supported by a grant from the Research On Rare And Intractable Diseases, Health and Labour Sciences: a Large-scale multi-institutional research committee aiming at an epidemiological survey of spondyloarthritis, creation of diagnostic criteria, and development of clinical guidelines.