PRECISION MEDICINE AND TARGETED IMMUNOTHERAPY IN AXIAL SPONDYLOARTHRITIS: CONTEMPORARY STRATEGIES, MECHANISTIC INSIGHTS, AND FUTURE DIRECTIONS

Axial spondyloarthritis represents a chronic, immune-mediated inflammatory disorder characterized predominantly by inflammation of the sacroiliac joints and spine, progressive structural remodeling, and varying degrees of functional impairment. Ankylosing spondylitis constitutes the radiographic form of axial spondyloarthritis and remains the most extensively studied phenotype within this disease spectrum. Traditionally conceptualized as a musculoskeletal disorder leading to spinal ankylosis and disability, axial spondyloarthritis is now recognized as a complex systemic condition involving genetic susceptibility, dysregulated innate and adaptive immune responses, and environmental triggers. The modern therapeutic landscape has shifted dramatically over the past two decades, transitioning from symptom-centered management to targeted immunomodulation and personalized treatment strategies.