INTEGRATED MULTIMODAL MANAGEMENT OF AXIAL SPONDYLOARTHRITIS: CONTEMPORARY EVIDENCE, CLINICAL ALGORITHMS, AND FUTURE THERAPEUTIC HORIZONS

Axial spondyloarthritis is a chronic, immune-mediated inflammatory disorder primarily affecting the sacroiliac joints and spine, with the potential to cause progressive structural remodeling, chronic pain, and functional limitation. Ankylosing spondylitis represents the radiographic stage of this disease spectrum and has historically been considered its prototypical manifestation. Over the last several decades, understanding of axial spondyloarthritis has evolved substantially, transforming it from a condition primarily associated with spinal ankylosis into a complex systemic inflammatory disease with heterogeneous phenotypes, variable progression rates, and diverse therapeutic responses.