Why Treatment Fails in Axial Spondyloarthritis — And What We Can Do About It

Why Treatment Fails in Axial Spondyloarthritis — And What We Can Do About It

RheumaCast · 2025-04-25
08:31

In this episode of RheumaCast, we discuss one of the most frustrating aspects of axial spondyloarthritis (axSpA): treatment failure. Despite the availability of multiple biologic and targeted therapies, over half of patients do not achieve remission.

What causes this non-response? We explore two major culprits—misdiagnosis and the presence of nociplastic pain—and examine how imaging pitfalls, overlapping mechanical conditions like osteitis condensans ilii, and inadequate communication between clinicians and radiologists can lead to suboptimal management. Learn how standardized MRI protocols, expert interpretation, and emerging tools like AI and molecular imaging can improve diagnostic precision and patient outcomes.

This episode is based on the publication: Poddubnyy D and Baraliakos X. Nat Rev Rheumatol 2025; doi:10.1038/s41584-025-01254-5 and developed with NotebookLM.

RheumaCast

RheumaCast dives into the latest developments in rheumatology, offering in-depth discussions on research, clinical advances, and expert comments. Each episode sheds light on significant publications, upcoming events, and evolving trends in the field. Perfect for rheumatologists, healthcare professionals, and researchers eager to stay at the forefront of rheumatology.

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