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Open research questions in Spondyloarthritis Studies and Treatments

147 unresolved questions extracted from the limitations and future-work sections of 474 Spondyloarthritis Studies and Treatments papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Clinical trials were usually underpowered to explore sex differences, - Current evidence on the role of sex hormones remains inconsistent, - The study relies on observational studies and systematic reviews, - Conflicting evidence exists across multiple studies

    Sex, Sex Hormones and Inflammatory Burden and Cardiovascular Risk in Patients with Spondyloarthritis · 2026 · DOI

  • An integrated review of the role of sex in shaping inflammatory burden and CV risk in SpA is warranted, - Further studies are needed to explore the mechanisms underlying sex differences in spondyloarthritis, - Research on the impact of sex hormones on immune regulation and inflammation in SpA is needed

    Sex, Sex Hormones and Inflammatory Burden and Cardiovascular Risk in Patients with Spondyloarthritis · 2026 · DOI

  • However, it remains uncertain whether this association reflects a causal association.

    Genetically predicted ankylosing spondylitis increases the risk of heart failure: a Mendelian randomization study · 2025 · DOI

  • Our findings underscore the need for further investigation into the interplay between HERV sequences, viral mimicry, and immune tolerance to identify novel therapeutic strategies targeting AS at its genetic and immunological roots.

    Can single nucleotide variations in human endogenous retroviral sequences affect peptide presentation by HLA-B27: implications for viral mimicry and ankylosing spondylitis? 3534 · 2025 · DOI

  • Our study hypothesizes that this SNV-induced missense mutation (methionine to threonine) may lead to differential T cell selection during immune development, where HSV peptides that mimic self-proteins are insufficiently tolerated.

    Can single nucleotide variations in human endogenous retroviral sequences affect peptide presentation by HLA-B27: implications for viral mimicry and ankylosing spondylitis? 3534 · 2025 · DOI

  • There is growing evidence that ankylosing spondylitis is closely linked to AS, often co-occurring with it; however, the shared pathogenic mechanisms between the two conditions are not well understood.

    Exploring the common mechanisms and biomarker ST8SIA4 of atherosclerosis and ankylosing spondylitis through bioinformatics analysis and machine learning · 2024 · DOI

  • Despite established links between SpA and HLA-B27-associated AAU, the exact mechanism involved remains unclear, and further understanding is needed for effective prevention and treatment.

    Investigation of the acute pathogenesis of spondyloarthritis/HLA-B27-associated anterior uveitis based on genome-wide association analysis and single-cell transcriptomics · 2024 · DOI

  • High heterogeneity among the included studies. Limited understanding of the pharmacological mechanisms of TGP in treating AS. Need for alternative therapies for AS.

    Efficacy and potential pharmacological mechanisms of total glucosides of paeony in treating ankylosing spondylitis in Asian populations: a meta-analysis, network pharmacology, and molecular dynamics simulation · 2026 · DOI

  • There is a lack of evidence on the efficacy of TGP in treating AS in Asian populations. The current treatment options for AS have limitations, and there is a need for alternative therapies. The pharmacological mechanisms of TGP in treating AS are not well understood.

    Efficacy and potential pharmacological mechanisms of total glucosides of paeony in treating ankylosing spondylitis in Asian populations: a meta-analysis, network pharmacology, and molecular dynamics simulation · 2026 · DOI

  • Plaque psoriasis is a chronic and debilitating disease that significantly impacts patients' physical and psychological well-being. The disease can be challenging to treat, with limited treatment options available. Secukinumab is a relatively new treatment option, and its long-term effectiveness and safety are not well established.

    Retention, Effectiveness, and Safety of Secukinumab in Plaque Psoriasis: 5-Year Results from SERENA · 2026 · DOI

  • There is a need to assess the long-term effectiveness and safety of secukinumab in treating plaque psoriasis. The study aims to fill this gap by evaluating the retention rates and disease severity of secukinumab over 5 years.

    Retention, Effectiveness, and Safety of Secukinumab in Plaque Psoriasis: 5-Year Results from SERENA · 2026 · DOI

  • 2021. Nat. Rev. Rheumatol. 18, 465-479 (2022). 11. Mease, P. J. et al. Secukinumab inhibition of interleukin-17A in patients with psoriatic arthritis. N. Engl. J. Med. 373, 1329-1339 (2015). 12. McInnes, I. B. et al. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 386, 1137-1146 (2015). 13. Nash, P. et al. Efficacy and safety of secukinumab administration by autoinjector in patients with psoriatic arthritis: results from a randomized, placebo-controlled trial (FUTURE 3). Arthritis Res. Ther. 20, 47 (2018). 14. Kivitz, A. J. et al. Efficacy and safety of subcutaneous secukinumab 150 mg with or without in psoriatic arthritis: results from the FUTURE 4 study. Rheumatol. Ther. 6, 393-407 (2019). regimen loading 15. Mease, P. et al. Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study. Ann. Rheum. Dis. 77, 890-897 (2018). 16. EMA.

    Using causal machine learning and real world data to improve dose response decision making for secukinumab in psoriatic arthritis · 2026 · DOI

  • Real-world data on secukinumab in Chinese psoriatic arthritis patients are limited. There is a need for studies to evaluate the effectiveness and safety of secukinumab in a real-world setting.

    Real-world skin and dermatology-specific quality-of-life outcomes and a nomogram to predict skin response to secukinumab in Chinese psoriatic arthritis patients: a multicenter retrospective cohort study · 2026 · DOI

  • Lack of specific diagnostic criteria for IBD-SpA. Delayed diagnosis due to clinical heterogeneity.

    The role of a multidisciplinary approach in the early and differential diagnosis of inflammatory bowel disease–related spondyloarthritis: insights from a cross-sectional study · 2026 · DOI

  • Axial spondyloarthritis is a chronic and progressive disease. The disease has a heterogeneous clinical phenotype. There is a need for effective treatment strategies for axSpA.

    Interrelations of disease activity, health-related quality of life, and mental health in axial spondyloarthritis: the Rheuma-VOR cohort · 2026 · DOI

  • The aetiology of MJD remains unknown. Treatment-seeking behaviors in MJD are influenced by systemic, social, and cultural factors.

    Understanding barriers to treatment-seeking in Mseleni joint disease: A multistaged study in rural KwaZulu-Natal, South Africa · 2026 · DOI

  • The aetiology of MJD remains unknown. There is a lack of understanding of treatment-seeking behaviors in MJD from the perspectives of patients and healthcare providers.

    Understanding barriers to treatment-seeking in Mseleni joint disease: A multistaged study in rural KwaZulu-Natal, South Africa · 2026 · DOI

  • There is limited insight into how developments in classification, imaging, and disease-activity assessment are addressed in daily clinical practice. There is a need to explore if non-radiographic axial spondyloarthritis is addressed differently from radiographic axial spondyloarthritis.

    Challenges in diagnosing and monitoring radiographic and non-radiographic axial spondyloarthritis in daily clinical practice · 2026 · DOI

  • There is a need to understand the mechanisms of paradoxical reactions to biological agents in the treatment of ankylosing spondylitis. The paper highlights the importance of considering alternative treatments in patients who develop paradoxical reactions.

    Upadacitinib for atopic dermatitis induced by secukinumab in patients with refractory ankylosing spondylitis:a case report · 2026 · DOI

  • The study faces challenges in terms of limited sample size and reliance on self-reported data. The diagnosis of fibromyalgia can be challenging, and the study uses the 1990 ACR criteria. The study must account for the potential impact of confounding variables on the results.

    Axial spondyloarthritis patients with comorbid fibromyalgia feel worse, work less and more often try multiple biological therapies: results from a population-based, cross-sectional study investigating the discriminative capacity of pressure algometry · 2026 · DOI

  • The study has a limited sample size, which may affect the generalizability of the results. The study does not include a control group of healthy individuals for comparison. The study relies on self-reported data, which may be subject to bias.

    Axial spondyloarthritis patients with comorbid fibromyalgia feel worse, work less and more often try multiple biological therapies: results from a population-based, cross-sectional study investigating the discriminative capacity of pressure algometry · 2026 · DOI

  • There is a need to investigate the discrepancies in the assessment of axial spondyloarthritis between patients and rheumatologists. The determinants of the overall patient assessment and the factors influencing the rheumatologist's overall assessment are not well understood.

    Discrepancies in the assessment of axial spondyloarthritis between patients and rheumatologists: what does this mean? · 2026 · DOI

  • Practical prediction tools for CVD risk in r-axSpA patients remain limited. There is a need for a risk stratification model that can identify patients with r-axSpA who are at high risk of CVD.

    Development and validation of a risk stratification model for cardiovascular disease in patients with radiographic axial spondyloarthritis (r-axSpA): a retrospective study · 2026 · DOI

  • Future studies should investigate the mechanisms underlying the increased risk of postoperative complications in IBD patients. Future studies should develop strategies to mitigate the risk of postoperative complications in IBD patients. Future studies should evaluate the long-term outcomes of lumbar spine surgery in IBD patients.

    Postoperative Complications After Lumbar Spinal Surgery in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis · 2026 · DOI

  • There is a lack of comprehensive assessments of the association between IBD and postoperative complications after lumbar spine surgery. There is a need to evaluate the comparative outcomes of lumbar spinal surgery in patients with and without IBD.

    Postoperative Complications After Lumbar Spinal Surgery in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis · 2026 · DOI

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147 open questions have been extracted from the limitations and future-work passages of 474 Spondyloarthritis Studies and Treatments papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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