Highlights from the SPARTAN Meeting 2016 (Part 1)
By David Borenstein MD, Executive Editor, theSpineCommunity.com
SPARTAN (Spondyloarthritis Research and Training Network) is the scientific organization of physicians and patient organizations dedicated to the study of inflammatory disorders of the spine, like ankylosing spondylitis. The 14th meeting of this group brought researchers from North America to Denver to discuss new advances in these disorders as well as the development of treatment recommendations for spondyloarthritis.
New treatment guidelines were published in 2015 but already have an omission as a treatment option. Cosentyx (secukinumab), an IL-17 inhibitor, was approved by the Food and Drug Administration for the treatment of ankylosing spondylitis, psoriasis, and psoriatic arthritis in 2016. This biologic agent is not included in the current guideline published in 2015. Efforts are underway to get this biologic drug included in a revised guideline. The addition of this biologic is important since some insurance plans use the guidelines, which are really recommendations, as a reason for approving or denying therapies to individuals who require them.
Another scientific session presented the concept of minimal disease activity or MDA. Disease activity scores usually measure how active a disease may be in an individual patient. Various measurement scales are available to determine the degree of inflammation in a patient with ankylosing spondylitis. However, no agreement exists on the criteria to designate an individual in a remission in ankylosing spondylitis. This concept is important in the care of AS patients. Patients ask very reasonable questions: Will I need to take this drug for the rest of my life? How does a doctor decide that the patient no longer needs the drug? Describing the parameters that will be used to determine the presence of remission is an important step in answering these questions. SPARTAN will be forming a group that will work with researchers from around the world to determine remission criteria.
Ward MM, Deodhar A, Aki EA, Lui A, Ermann J,Gensler LS, Smith JA, Borenstein D, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis RHeumatol 2016;68:282-98.
Caplan L, Deodhar A, Gensler L, Maksymowych W. Session on Classification Criteria for Axial Spondyloarthritis . Proceedings from the 2016 Annual Spartan meeting.
Deodhar A, Gensler L, Mease P, Walsh J. Axial spondyloasrthritis Minimal Disease Activity (MDA) development. Proceedings from the 2016 Annual Spartan meeting.