{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:02:27Z","timestamp":1762081347430,"version":"build-2065373602"},"reference-count":86,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The term \u201caxial spondyloarthritis\u201d (axSpA) refers to a group of chronic rheumatic diseases that predominantly involve the axial skeleton and consist of ankylosing spondylitis, reactive arthritis, arthritis\/spondylitis associated with psoriasis (PsA) and arthritis\/spondylitis associated with inflammatory bowel diseases (IBD). Moreover, pain is an important and common symptom of axSpA. It may progress to chronic pain, a more complicated bio-psychosocial phenomena, leading to a significant worsening of quality of life. The development of the axSpA inflammatory process is grounded in the complex interaction between genetic (such as HLA B27), epigenetic, and environmental factors associated with a dysregulated immune response. Considering the pivotal contribution of IL-23 and IL-17 in axSpA inflammation, the inhibition of these cytokines has been evaluated as a potential therapeutic strategy. With this context, here we discuss the main pathogenetic mechanisms, therapeutic approaches and the role of pain in axSpA from the 2022 International GISEA\/OEG Symposium.<\/jats:p>","DOI":"10.3390\/jcm11247537","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T08:41:41Z","timestamp":1671439301000},"page":"7537","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Axial Spondyloarthritis: Reshape the Future\u2014From the \u201c2022 GISEA International Symposium\u201d"],"prefix":"10.3390","volume":"11","author":[{"given":"Fausto","family":"Salaffi","sequence":"first","affiliation":[{"name":"Rheumatology Clinic, Ospedale Carlo Urbani, Universit\u00e0 Politecnica delle Marche, 60035 Jesi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesare","family":"Siragusano","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8971-4696","authenticated-orcid":false,"given":"Alessandra","family":"Alciati","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Como, and Humanitas Clinical and Research Centre, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3454-401X","authenticated-orcid":false,"given":"Giulia","family":"Cassone","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Azienda Ospedaliera Policlinico di Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"D\u2019Angelo","sequence":"additional","affiliation":[{"name":"Rheumatology Institute of Lucania and Rheumatology Department of Lucania, San Carlo Hospital of Potenza, 85100 Potenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Guiducci","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ennio","family":"Favalli","sequence":"additional","affiliation":[{"name":"Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Conti","sequence":"additional","affiliation":[{"name":"Lupus Clinic, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Gremese","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0474-5344","authenticated-orcid":false,"given":"Florenzo","family":"Iannone","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Caporali","sequence":"additional","affiliation":[{"name":"Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-6421","authenticated-orcid":false,"given":"Marco","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Azienda Ospedaliera Policlinico di Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian","family":"Ferraccioli","sequence":"additional","affiliation":[{"name":"School of Medicine, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8427-6092","authenticated-orcid":false,"given":"Giovanni","family":"Lapadula","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiola","family":"Atzeni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.mayocp.2021.08.007","article-title":"A Road Map of the Axial Spondyloarthritis Continuum","volume":"97","author":"Schwartzman","year":"2022","journal-title":"Mayo Clin. Proc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.55563\/clinexprheumatol\/jlyd1l","article-title":"One Year in Review 2021: Axial Spondyloarthritis","volume":"39","author":"Cardelli","year":"2021","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1365-2567.2011.03522.x","article-title":"Interleukin-23: As a Drug Target for Autoimmune Inflammatory Diseases","volume":"135","author":"Tang","year":"2012","journal-title":"Immunology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.4049\/jimmunol.176.2.1098","article-title":"IL-23 Enhances the Inflammatory Cell Response in Cryptococcus Neoformans Infection and Induces a Cytokine Pattern Distinct from IL-12","volume":"176","author":"Kleinschek","year":"2006","journal-title":"J. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/s41413-019-0057-8","article-title":"Ankylosing Spondylitis: Etiology, Pathogenesis, and Treatments","volume":"7","author":"Zhu","year":"2019","journal-title":"Bone Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.3892\/mmr.2017.6248","article-title":"Role of HLA-B27 in the Pathogenesis of Ankylosing Spondylitis (Review)","volume":"15","author":"Chen","year":"2017","journal-title":"Mol. Med. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1002\/art.24763","article-title":"HLA-B27 Misfolding and the Unfolded Protein Response Augment Interleukin-23 Production and Are Associated with Th17 Activation in Transgenic Rats","volume":"60","author":"DeLay","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3586","DOI":"10.1002\/art.21395","article-title":"Expansion and Enhanced Survival of Natural Killer Cells Expressing the Killer Immunoglobulin-like Receptor KIR3DL2 in Spondylarthritis","volume":"52","author":"Chan","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2976","DOI":"10.1002\/art.38809","article-title":"Endoplasmic Reticulum Degradation-Enhancing \u03b1-Mannosidase-like Protein 1 Targets Misfolded HLA-B27 Dimers for Endoplasmic Reticulum-Associated Degradation","volume":"66","author":"Guiliano","year":"2014","journal-title":"Arthritis Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1038\/ni860","article-title":"The ER Aminopeptidase ERAP1 Enhances or Limits Antigen Presentation by Trimming Epitopes to 8-9 Residues","volume":"3","author":"York","year":"2002","journal-title":"Nat. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"7146","DOI":"10.1038\/ncomms8146","article-title":"Major Histocompatibility Complex Associations of Ankylosing Spondylitis Are Complex and Involve Further Epistasis with ERAP1","volume":"6","author":"Cortes","year":"2015","journal-title":"Nat. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1002\/art.24389","article-title":"Overexpression of Interleukin-23, but Not Interleukin-17, as an Immunologic Signature of Subclinical Intestinal Inflammation in Ankylosing Spondylitis","volume":"60","author":"Ciccia","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/art.38967","article-title":"Brief Report: Intestinal Dysbiosis in Ankylosing Spondylitis","volume":"67","author":"Costello","year":"2015","journal-title":"Arthritis Rheumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1136\/annrheumdis-2016-210000","article-title":"Dysbiosis and Zonulin Upregulation Alter Gut Epithelial and Vascular Barriers in Patients with Ankylosing Spondylitis","volume":"76","author":"Ciccia","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1136\/annrheumdis-2013-203643","article-title":"Proof of Concept: Enthesitis and New Bone Formation in Spondyloarthritis Are Driven by Mechanical Strain and Stromal Cells","volume":"73","author":"Jacques","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/art.40728","article-title":"Three Multicenter, Randomized, Double-Blind, Placebo-Controlled Studies Evaluating the Efficacy and Safety of Ustekinumab in Axial Spondyloarthritis","volume":"71","author":"Deodhar","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1136\/annrheumdis-2018-213328","article-title":"Risankizumab, an IL-23 Inhibitor, for Ankylosing Spondylitis: Results of a Randomised, Double-Blind, Placebo-Controlled, Proof-of-Concept, Dose-Finding Phase 2 Study","volume":"77","author":"Baeten","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaut.2017.12.007","article-title":"A Cellular and Molecular View of T Helper 17 Cell Plasticity in Autoimmunity","volume":"87","author":"Stadhouders","year":"2018","journal-title":"J. Autoimmun."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1002\/art.37704","article-title":"Disease-Specific and Inflammation-Independent Stromal Alterations in Spondylarthritis Synovitis","volume":"65","author":"Yeremenko","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s13075-016-1046-6","article-title":"Interaction among Activated Lymphocytes and Mesenchymal Cells through Podoplanin Is Critical for a High IL-17 Secretion","volume":"18","author":"Noack","year":"2016","journal-title":"Arthritis Res. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/cei.12830","article-title":"Role of Podoplanin in the High Interleukin-17A Secretion Resulting from Interactions between Activated Lymphocytes and Psoriatic Skin-Derived Mesenchymal Cells","volume":"186","author":"Noack","year":"2016","journal-title":"Clin. Exp. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1038\/ni.3579","article-title":"Regulation of Autoantibody Activity by the IL-23-TH17 Axis Determines the Onset of Autoimmune Disease","volume":"18","author":"Pfeifle","year":"2017","journal-title":"Nat. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.clim.2018.09.002","article-title":"Pathophysiology and Inhibition of IL-23 Signaling in Psoriatic Arthritis: A Molecular Insight","volume":"206","author":"Nguyen","year":"2019","journal-title":"Clin. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.jbspin.2006.11.005","article-title":"Serum IL-17, BMP-7, and Bone Turnover Markers in Patients with Ankylosing Spondylitis","volume":"74","author":"Wendling","year":"2007","journal-title":"Jt. Bone Spine"},{"key":"ref_25","first-page":"828","article-title":"Association between Th-17 cytokine profile and clinical features in patients with spondyloarthritis","volume":"29","author":"Jaimes","year":"2011","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jcma.2012.05.006","article-title":"Association of Serum Interleukin-17 and Interleukin-23 Levels with Disease Activity in Chinese Patients with Ankylosing Spondylitis","volume":"75","author":"Chen","year":"2012","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s10875-012-9774-0","article-title":"Levels of Circulating Th17 Cells and Regulatory T Cells in Ankylosing Spondylitis Patients with an Inadequate Response to Anti-TNF-\u03b1 Therapy","volume":"33","author":"Xueyi","year":"2013","journal-title":"J. Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1186\/s13075-014-0426-z","article-title":"Heterogeneous Expression Pattern of Interleukin 17A (IL-17A), IL-17F and Their Receptors in Synovium of Rheumatoid Arthritis, Psoriatic Arthritis and Osteoarthritis: Possible Explanation for Nonresponse to Anti-IL-17 Therapy?","volume":"16","author":"Lebre","year":"2014","journal-title":"Arthritis Res. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1136\/annrheumdis-2017-212127","article-title":"Dual IL-17A and IL-17F Neutralisation by Bimekizumab in Psoriatic Arthritis: Evidence from Preclinical Experiments and a Randomised Placebo-Controlled Clinical Trial That IL-17F Contributes to Human Chronic Tissue Inflammation","volume":"77","author":"Glatt","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1097\/MIB.0b013e318286fa1c","article-title":"TH17 Cell Induction and Effects of IL-17A and IL-17F Blockade in Experimental Colitis","volume":"19","author":"Schmidt","year":"2013","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"L1283","DOI":"10.1152\/ajplung.00367.2005","article-title":"IL-17A Acts via P38 MAPK to Increase Stability of TNF-Alpha-Induced IL-8 MRNA in Human ASM","volume":"290","author":"Henness","year":"2006","journal-title":"Am. J. Physiol. Lung Cell. Mol. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/s41584-018-0044-2","article-title":"IL-17 in the Immunopathogenesis of Spondyloarthritis","volume":"14","author":"Taams","year":"2018","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.imlet.2016.05.001","article-title":"IL-17+ CD8+ T Cells: Differentiation, Phenotype and Role in Inflammatory Disease","volume":"178","author":"Srenathan","year":"2016","journal-title":"Immunol. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1038\/ni.3726","article-title":"IL-17+ \u0393\u03b4 T Cells as Kick-Starters of Inflammation","volume":"18","author":"Papotto","year":"2017","journal-title":"Nat. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1182\/blood-2013-11-427781","article-title":"Human Innate Lymphoid Cells","volume":"124","author":"Hazenberg","year":"2014","journal-title":"Blood"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1002\/art.41042","article-title":"2019 Update of the American College of Rheumatology\/Spondylitis Association of America\/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis","volume":"71","author":"Ward","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2147\/ITT.S259126","article-title":"Anti-IL-17 Agents in the Treatment of Axial Spondyloarthritis","volume":"10","author":"Atzeni","year":"2021","journal-title":"ImmunoTargets Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/S0140-6736(13)61134-4","article-title":"Anti-Interleukin-17A Monoclonal Antibody Secukinumab in Treatment of Ankylosing Spondylitis: A Randomised, Double-Blind, Placebo-Controlled Trial","volume":"382","author":"Baeten","year":"2013","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1056\/NEJMoa1505066","article-title":"Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis","volume":"373","author":"Baeten","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1136\/annrheumdis-2016-210023","article-title":"Secukinumab Efficacy in Anti-TNF-Naive and Anti-TNF-Experienced Subjects with Active Ankylosing Spondylitis: Results from the MEASURE 2 Study","volume":"76","author":"Sieper","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/14397595.2018.1538004","article-title":"Efficacy and Safety of Secukinumab in Japanese Patients with Active Ankylosing Spondylitis: 24-Week Results from an Open-Label Phase 3 Study (MEASURE 2-J)","volume":"30","author":"Kishimoto","year":"2020","journal-title":"Mod. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1186\/s13075-017-1490-y","article-title":"Efficacy, Safety, and Tolerability of Secukinumab in Patients with Active Ankylosing Spondylitis: A Randomized, Double-Blind Phase 3 Study, MEASURE 3","volume":"19","author":"Pavelka","year":"2017","journal-title":"Arthritis Res. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s40744-018-0123-5","article-title":"Efficacy and Safety of Secukinumab 150 Mg with and without Loading Regimen in Ankylosing Spondylitis: 104-Week Results from MEASURE 4 Study","volume":"5","author":"Kivitz","year":"2018","journal-title":"Rheumatol. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1517\/14712598.2016.1167183","article-title":"Secukinumab (AIN457) in the Treatment of Ankylosing Spondylitis","volume":"16","author":"Braun","year":"2016","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/art.41477","article-title":"Improvement of Signs and Symptoms of Nonradiographic Axial Spondyloarthritis in Patients Treated with Secukinumab: Primary Results of a Randomized, Placebo-Controlled Phase III Study","volume":"73","author":"Deodhar","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1080\/14712598.2020.1761957","article-title":"One-Year Effectiveness, Retention Rate, and Safety of Secukinumab in Ankylosing Spondylitis and Psoriatic Arthritis: A Real-Life Multicenter Study","volume":"20","author":"Chimenti","year":"2020","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e001280","DOI":"10.1136\/rmdopen-2020-001280","article-title":"Drug Retention, Inactive Disease and Response Rates in 1860 Patients with Axial Spondyloarthritis Initiating Secukinumab Treatment: Routine Care Data from 13 Registries in the EuroSpA Collaboration","volume":"6","author":"Michelsen","year":"2020","journal-title":"RMD Open"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s40259-020-00442-x","article-title":"Drug Survival of Biologics in Treating Ankylosing Spondylitis: A Systematic Review and Meta-Analysis of Real-World Evidence","volume":"34","author":"Yu","year":"2020","journal-title":"BioDrugs"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1016\/S0140-6736(18)31946-9","article-title":"Ixekizumab, an Interleukin-17A Antagonist in the Treatment of Ankylosing Spondylitis or Radiographic Axial Spondyloarthritis in Patients Previously Untreated with Biological Disease-Modifying Anti-Rheumatic Drugs (COAST-V): 16 Week Results of a Phase 3 Randomised, Double-Blind, Active-Controlled and Placebo-Controlled Trial","volume":"392","author":"Dougados","year":"2018","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1002\/art.40753","article-title":"Efficacy and Safety of Ixekizumab in the Treatment of Radiographic Axial Spondyloarthritis: Sixteen-Week Results from a Phase III Randomized, Double-Blind, Placebo-Controlled Trial in Patients with Prior Inadequate Response to or Intolerance of Tumor Necrosis Factor Inhibitors","volume":"71","author":"Deodhar","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1056\/NEJMoa1109017","article-title":"Brodalumab, an Anti-Interleukin-17-Receptor Antibody for Psoriasis","volume":"366","author":"Papp","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jaad.2017.08.024","article-title":"Psychiatric Adverse Events during Treatment with Brodalumab: Analysis of Psoriasis Clinical Trials","volume":"78","author":"Lebwohl","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1136\/annrheumdis-2020-219406","article-title":"Efficacy and Safety of Brodalumab, an Anti-IL17RA Monoclonal Antibody, in Patients with Axial Spondyloarthritis: 16-Week Results from a Randomised, Placebo-Controlled, Phase 3 Trial","volume":"80","author":"Wei","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1136\/annrheumdis-2020-216980","article-title":"Dual Neutralisation of Interleukin-17A and Interleukin-17F with Bimekizumab in Patients with Active Ankylosing Spondylitis: Results from a 48-Week Phase IIb, Randomised, Double-Blind, Placebo-Controlled, Dose-Ranging Study","volume":"79","author":"Gensler","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_55","first-page":"27","article-title":"Primary Efficacy of Netakimab, a Novel Interleukin-17 Inhibitor, in the Treatment of Active Ankylosing Spondylitis in Adults","volume":"38","author":"Erdes","year":"2020","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1136\/annrheumdis-2015-209068","article-title":"Efficacy and Safety of Ustekinumab in Psoriatic Arthritis Patients with Peripheral Arthritis and Physician-Reported Spondylitis: Post-Hoc Analyses from Two Phase III, Multicentre, Double-Blind, Placebo-Controlled Studies (PSUMMIT-1\/PSUMMIT-2)","volume":"75","author":"Kavanaugh","year":"2016","journal-title":"Ann. Rheum. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e001149","DOI":"10.1136\/rmdopen-2019-001149","article-title":"Effects of Ustekinumab on Spondylitis-Associated Endpoints in TNFi-Na\u00efve Active Psoriatic Arthritis Patients with Physician-Reported Spondylitis: Pooled Results from Two Phase 3, Randomised, Controlled Trials","volume":"6","author":"Helliwell","year":"2020","journal-title":"RMD Open"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1136\/annrheumdis-2020-eular.474","article-title":"Op0054 Efficacy of Guselkumab, a Monoclonal Antibody that Specifically Binds to the P19-Subunit of Il-23, on Endpoints Related to Axial Involvement in Patients with Active Psa with Imaging-Confirmed Sacroiliitis: Week-24 Results from Two Phase 3, Randomized, Double-Blind, Placebo-Controlled Studies","volume":"79","author":"Helliwell","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1136\/annrheumdis-2021-221422","article-title":"No Efficacy of Anti-IL-23 Therapy for Axial Spondyloarthritis in Randomised Controlled Trials but in Post-Hoc Analyses of Psoriatic Arthritis-Related \u201cPhysician-Reported Spondylitis\u201d?","volume":"81","author":"Braun","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"623874","DOI":"10.3389\/fimmu.2020.623874","article-title":"IL-23 Inhibition in Ankylosing Spondylitis: Where Did It Go Wrong?","volume":"11","author":"Baeten","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1136\/annrheumdis-2013-204248","article-title":"Ustekinumab for the Treatment of Patients with Active Ankylosing Spondylitis: Results of a 28-Week, Prospective, Open-Label, Proof-of-Concept Study (TOPAS)","volume":"73","author":"Poddubnyy","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1080\/14712598.2022.2090834","article-title":"IL-23 in Axial Spondyloarthritis and Psoriatic Arthritis: A Good Fit for Biological Treatment?","volume":"22","author":"Atzeni","year":"2022","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_63","first-page":"S102","article-title":"Causes of Pain in Patients with Axial Spondyloarthritis","volume":"35","author":"Kiltz","year":"2017","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1093\/rheumatology\/kew303","article-title":"Fluctuations in Patient Reported Disease Activity, Pain and Global Being in Patients with Ankylosing Spondylitis","volume":"55","author":"Essers","year":"2016","journal-title":"Rheumatology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1037\/0033-2909.133.4.581","article-title":"The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions","volume":"133","author":"Gatchel","year":"2007","journal-title":"Psychol. Bull."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3419","DOI":"10.1007\/s00167-018-4914-6","article-title":"Central Sensitization Is a Risk Factor for Wound Complications after Primary Total Knee Arthroplasty. Knee Surg","volume":"26","author":"Kim","year":"2018","journal-title":"Sports Traumatol. Arthrosc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.pain.2008.04.025","article-title":"The Kyoto Protocol of IASP Basic Pain Terminology","volume":"137","author":"Loeser","year":"2008","journal-title":"Pain"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/ALN.0000000000002130","article-title":"Neuroinflammation and Central Sensitization in Chronic and Widespread Pain","volume":"129","author":"Ji","year":"2018","journal-title":"Anesthesiology"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1002\/art.37920","article-title":"Neuropathic Pain in Ankylosing Spondylitis: A Psychophysics and Brain Imaging Study","volume":"65","author":"Wu","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17826\/cumj.503652","article-title":"Should Central Sensitization and Neuropathic Pain Be Considered in Disease Activity and Treatment Decision in Axial Ankylosing Spondilitis?","volume":"44","author":"Koca","year":"2019","journal-title":"Cukurova Med. J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4081\/reumatismo.2014.761","article-title":"Chronic Widespread Pain in Spondyloarthritis","volume":"66","author":"Atzeni","year":"2014","journal-title":"Reumatismo"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Rifbjerg-Madsen, S., Christensen, A.W., Christensen, R., Hetland, M.L., Bliddal, H., Kristensen, L.E., Danneskiold-Sams\u00f8e, B., and Amris, K. (2017). Pain and Pain Mechanisms in Patients with Inflammatory Arthritis: A Danish Nationwide Cross-Sectional DANBIO Registry Survey. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0180014"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.pain.2011.06.017","article-title":"A New Definition of Neuropathic Pain","volume":"152","author":"Jensen","year":"2011","journal-title":"Pain"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.1007\/s10067-018-4125-z","article-title":"Association of Neuropathic-like Pain Characteristics with Clinical and Radiographic Features in Patients with Ankylosing Spondylitis","volume":"37","author":"Choi","year":"2018","journal-title":"Clin. Rheumatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/RHU.0000000000000711","article-title":"Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden","volume":"24","author":"Gok","year":"2018","journal-title":"J. Clin. Rheumatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s10067-019-04749-1","article-title":"The Important Role of Central Sensitization in Chronic Musculoskeletal Pain Seen in Different Rheumatic Diseases","volume":"39","author":"Guler","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/sjop.12592","article-title":"Pain Appraisal and Quality of Life in 108 Outpatients with Rheumatoid Arthritis","volume":"61","author":"Larice","year":"2020","journal-title":"Scand. J. Psychol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.wneu.2017.04.166","article-title":"Central Sensitization Inventory as a Predictor of Worse Quality of Life Measures and Increased Length of Stay Following Spinal Fusion","volume":"104","author":"Bennett","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/papr.13162","article-title":"Validity of the Central Sensitization Inventory compared with traditional measures of disease severity in fibromyalgia","volume":"22","author":"Salaffi","year":"2022","journal-title":"Pain Pract."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1136\/annrheumdis-2019-216143","article-title":"Determining Factors Related to Poor Quality of Life in Patients with Axial Spondyloarthritis: Results from the British Society for Rheumatology Biologics Register (BSRBR-AS)","volume":"79","author":"Macfarlane","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3389\/fncel.2018.00035","article-title":"Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions","volume":"12","author":"Nicol","year":"2018","journal-title":"Front. Cell. Neurosci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 Fibromyalgia Diagnostic Criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"4476","DOI":"10.1093\/rheumatology\/keab019","article-title":"Central Sensitization, Illness Perception and Obesity Should Be Considered When Interpreting Disease Activity in Axial Spondyloarthritis","volume":"60","author":"Kieskamp","year":"2021","journal-title":"Rheumatology"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1093\/rheumatology\/kex318","article-title":"Patients with Fibromyalgia Rarely Fulfil Classification Criteria for Axial Spondyloarthritis","volume":"57","author":"Baraliakos","year":"2018","journal-title":"Rheumatology"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1007\/s00296-014-2955-9","article-title":"Fibromyalgia in Patients with Axial Spondyloarthritis: Epidemiological Profile and Effect on Measures of Disease Activity","volume":"34","author":"Salaffi","year":"2014","journal-title":"Rheumatol. Int."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"447","DOI":"10.36076\/ppj.2014\/17\/447","article-title":"Applying Modern Pain Neuroscience in Clinical Practice: Criteria for the Classification of Central Sensitization Pain","volume":"17","author":"Nijs","year":"2014","journal-title":"Pain Physician"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7537\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:44:15Z","timestamp":1760147055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,19]]},"references-count":86,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11247537"],"URL":"https:\/\/doi.org\/10.3390\/jcm11247537","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,12,19]]}}}