Page 145 - Recognizing axial spondyloarthritis - Janneke de Winter

The global aim of the studies described in this thesis was to increase the recognition of axial spondyloarthritis (axial SpA). Recognition by its two definitions: both acknowledgement as well as (early) identification of the disease. In this final chapter we will summarize the main findings of the studies in this thesis and share our vision of research challenges in the field for the coming years.
Figure 1. The spectrum of healthy to full-blown axial SpA, crossing subsequently the ‘at- risk’ phase, a phase characterized with back pain and other SpA features, and early axial SpA. The numbers on the left side represent the chapters in this thesis and their place in the disease spectrum. The disease probability increases with each following disease stage.
Recognizing the disease burden of axial SpA
To recognize and identify the magnitude and nature of disease manifestations in axial SpA is of importance for several reasons. First, treatment can only focus on the whole spectrum of disease manifestations in the patient with axial SpA if these manifestations are truly acknowledged. Second, exploring the heterogeneity between subsets of the disease (for example radiographic versus non-radiographic axial SpA) tells us in part whether axial SpA can be seen as one disease. Part I therefore elaborated on the disease burden of axial SpA. Chapter 2 aimed at describing the burden of peripheral disease (arthritis, enthesitis, dactylitis) in a real-life cohort of SpA patients fulfilling the ASAS criteria for axial or peripheral SpA. Of the SpA patients included, 230 fulfilled the axial and 84 the peripheral SpA criteria. Of the 230 axial SpA patients, 113 (49%) had purely axial disease
GENERAL DISCUSSION AND SUMMARY
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