TARGETED CYTOKINE INHIBITION VERSUS CONVENTIONAL IMMUNOMODULATION IN EARLY AXIAL SPONDYLOARTHRITIS: A 48-WEEK PROSPECTIVE COMPARATIVE STUDY

Axial spondyloarthritis is a chronic inflammatory rheumatic disease primarily affecting the sacroiliac joints and spine, leading to persistent back pain, stiffness, progressive structural damage, and functional limitation. It encompasses both radiographic and non-radiographic forms and predominantly affects young adults during their most productive years. The disease is characterized by immune-mediated inflammation at the entheses and axial skeleton, often associated with elevated acute-phase reactants and genetic predisposition, including HLA-B27 positivity. If inadequately controlled, axial spondyloarthritis may result in ankylosis, spinal deformity, and substantial impairment in quality of life.