Conditions
The following conditions are typically included in the group of seronegative spondylarthropathies:

Some sources also include Behçets disease and Whipples disease. Common characteristics
These diseases have the following conditions in common:

Seronegative (i.e. rheumatoid factor is not present)
They are in relation to HLA-B27
Inflammatory axial arthritis, generally sacroiliitis and spondylitis
Oligoarthritis, generally with asymmetrical presentation
Enthesitis (inflammation of the entheses, the sites where tendons or ligaments insert into the bone. ), e.g. Plantar fasciitis, Achilles tendinitis, costochondritis. Familial aggregation occurs
Extra-articular features, such as involvement of eyes (anterior uveitis), skin, genitourinary tract, and aortic regurgitation
Overlap is likely between several of the causative conditions

Classification
Assessment of Spondylarthritis International Society (ASAS criteria) is used for classification of axial spondyloarthritis (to be applied for patients with back pain greater than or equal to 3 months and age of onset less than 45 years). It is of two broad types:
Sacroiliitis on imaging plus 1 SpA feature, or
HLA-B27 plus 2 other SpA featuresSacroiliitis on imaging:
Active (acute) inflammation on MRI highly suggestive of SpA-associated sacroiliitis and/or
Definite radiographic sacroiliitisSpA features:
Inflammatory back pain
Arthritis
Enthesitis
Anterior uveitis
Dactylitis
Psoriasis
Crohns disease or ulcerative colitis
Good response to NSAIDs
Family history of SpA
HLA-B27
Elevated CRP

Treatment
Many patients have more than one of the spondyloarthritis disease manifestations. Some immunosuppressive drugs have shown efficacy in more than one of the diseases, e.g. tumor necrosis factor (TNF) inhibitors. But some of the immunosuppressive drugs are particularly effective for a specific inflamed tissue and approved in only one or two of the disease entities, so an interdisciplinary approach is required. Epidemiology
Worldwide prevalence of spondyloarthropathy is approximately 1.9%. References


== External links ==
Society and culture
Legal status
On 25 March 2021, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Efmody, intended for the treatment of congenital adrenal hyperplasia (CAH) in people aged twelve years and older. The applicant for this medicinal product is Diurnal Europe BV. Hydrocortisone (Efmody) was approved for medical use in the European Union, in May 2021, for the treatment of congenital adrenal hyperplasia (CAH) in people aged twelve years and older. Research
COVID-19
In September 2020, a meta-analysis study published by the World Health Organization (WHO) Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group found hydrocortisone to be effective in reducing mortality rate of critically ill COVID-19 patients when compared to other usual care or a placebo. References
External links
"Hydrocortisone". Drug Information Portal. U.S. National Library of Medicine.