{"title":"Vision prospective de la spondyloarthrite axiale : des progrès aux besoins non couverts","authors":"Daniel Wendling, Frank Verhoeven, Clément Prati","doi":"10.1016/j.rhum.2024.09.014","DOIUrl":"10.1016/j.rhum.2024.09.014","url":null,"abstract":"<div><div>La spondyloarthrite axiale a fait l’objet d’avancées importantes ces dernières années, avec l’apport de l’imagerie, de nouveaux critères de classification, l’importance du phénotype. Les connaissances immunopathologiques ont permis les progrès des traitements ciblés. Cependant, tout n’est pas résolu et des questions restent en suspens : le délai diagnostique reste long, la mortalité globale semble inchangée, le besoin de nouveaux biomarqueurs est réel ; la rémission est peu fréquente et l’effet structural des traitements difficile à montrer. Finalement, les performances d’efficacité des nouveaux traitements restent stables, il faut donc développer de nouvelles stratégies d’études et de traitement.</div></div><div><div>Axial spondyloarthritis has been the subject of significant advances in recent years, with the contribution of imaging, new classification criteria, and the importance of the phenotype. Immunopathological knowledge has enabled progress in targeted treatments. However, everything is not resolved and questions remain unanswered: the diagnostic delay remains long, overall mortality seems unchanged, the need for new biomarkers is real; remission is uncommon and the structural effect of treatments difficult to demonstrate. Finally, the effectiveness of new treatments remains stable, so new study and treatment strategies must be developed.</div></div>","PeriodicalId":38943,"journal":{"name":"Revue du Rhumatisme (Edition Francaise)","volume":"92 2","pages":"Pages 140-145"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Les spondyloarthrites difficiles à prendre en charge","authors":"Thao Pham , Léa Perrot , Benoit Flachaire , Théo Wirth","doi":"10.1016/j.rhum.2024.12.012","DOIUrl":"10.1016/j.rhum.2024.12.012","url":null,"abstract":"<div><div>Bien que des avancées thérapeutiques significatives aient permis d’améliorer la prise en charge des spondyloarthrites (SpA), une proportion substantielle de patients présente des symptômes résiduels et n’atteint pas la rémission. Ces formes \"réfractaires» ou « difficiles à traiter » (D2T) sont aujourd’hui caractérisées par une réponse insuffisante à plusieurs lignes de traitement ayant des mécanismes d’action différents, concept emprunté à celui de la polyarthrite rhumatoïde D2T. Cette définition est cependant insuffisante. La notion de SpA réfractaire non inflammatoire et de SpA réfractaire inflammatoire persistante est plus adaptée à la pratique clinique et permet d’adapter les propositions thérapeutiques en fonction. Les douleurs non inflammatoires, telles que les douleurs neuropathiques ou les atteintes mécaniques rachidiennes, sont des facteurs importants à considérer pour éviter des escalades thérapeutiques inutiles. Les données récentes suggèrent également que l’association de traitements ciblés pourrait offrir de nouvelles voies thérapeutiques pour les patients réfractaires inflammatoires, comme démontré dans d’autres pathologies inflammatoires.</div></div><div><div>Although significant therapeutic advances have improved the management of spondyloarthritis (SpA), a substantial proportion of patients continue to experience residual symptoms and do not achieve remission. These refractory, difficult-to-treat (D2T) forms, are currently characterized by an inadequate response to multiple lines of treatment with different mechanisms of action, a concept borrowed from the D2T rheumatoid arthritis framework. However, this definition is insufficient. The concept of non-inflammatory refractory SpA and persistently inflammatory refractory SpA is more suitable for clinical practice and allows for tailored therapeutic approaches accordingly. Non-inflammatory pain, such as neuropathic pain or mechanical spinal involvement, is important factors to consider in order to avoid unnecessary therapeutic escalations. Recent data also suggest that the combination of targeted therapies may offer new therapeutic avenues for refractory patients, as demonstrated in other inflammatory conditions.</div></div>","PeriodicalId":38943,"journal":{"name":"Revue du Rhumatisme (Edition Francaise)","volume":"92 2","pages":"Pages 171-175"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Épidémiologie et mesures de santé perçue (PRO)","authors":"Charlotte Jauffret","doi":"10.1016/j.rhum.2025.01.014","DOIUrl":"10.1016/j.rhum.2025.01.014","url":null,"abstract":"","PeriodicalId":38943,"journal":{"name":"Revue du Rhumatisme (Edition Francaise)","volume":"92 2","pages":"Pages 225-227"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Myopathies induites par les statines : une entité rare ?","authors":"Théo Wirth , Sandrine Guis","doi":"10.1016/j.rhum.2024.06.008","DOIUrl":"10.1016/j.rhum.2024.06.008","url":null,"abstract":"","PeriodicalId":38943,"journal":{"name":"Revue du Rhumatisme (Edition Francaise)","volume":"92 1","pages":"Pages 11-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johanna Sigaux , Luca Semerano , Marie-Christophe Boissier
{"title":"Polyarthrite rhumatoïde : nécessité de l’intégration du statut socio-économique dans les études d’expositions environnementales","authors":"Johanna Sigaux , Luca Semerano , Marie-Christophe Boissier","doi":"10.1016/j.rhum.2024.06.003","DOIUrl":"10.1016/j.rhum.2024.06.003","url":null,"abstract":"","PeriodicalId":38943,"journal":{"name":"Revue du Rhumatisme (Edition Francaise)","volume":"92 1","pages":"Pages 3-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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