Assessing the preclinical progress in the therapeutic targeting of axial spondyloarthritis.

INTRODUCTION: Axial spondyloarthritis (SpA) is a chronic inflammatory rheumatism affecting predominantly the axial skeleton and frequently also the peripheral joints, often associated with specific extra-musculoskeletal manifestations. This complex disease is still poorly understood resulting in a lack of cure. While symptomatic treatments are available, preclinical models/analyses are needed to identify new therapeutic targets in order to improve axial SpA treatment. AREAS COVERED: We discussed strengths and weaknesses of preclinical models used to identify and validate emerging therapeutic targets. EXPERT OPINION: Progress in developing new therapies for axial SpA remains slow due to its biological complexity and limited understanding of early disease mechanisms. Current treatments mainly target downstream inflammation, contributing to persistent unmet needs and variable responses. Future progress will rely on more pathophysiologically relevant models, interdisciplinary approaches, and integration of insights from related diseases to accelerate personalized therapeutic development.