Pulmonary manifestations of axial spondyloarthritis

Common extra-musculoskeletal manifestations (EMMs) of axial spondyloarthritis (axSpA) include uveitis, inflammatory bowel disease, and psoriasis; some of the uncommon manifestations include aortic valvular incompetence, cardiac conduction abnormalities, and IgA nephropathy. Very little is known about the pulmonary manifestations of axSpA, and this chapter reviews current knowledge of the pulmonary manifestations of axSpA. The most common pulmonary manifestation of axSpA is a restrictive ventilatory defect from either pleuroparenchymal or chest wall pathology. An increased incidence of obstructive pulmonary disease and an increased prevalence of obstructive sleep apnea (OSA) have also been observed. There is a paucity of data regarding pulmonary manifestations in patients with non-radiographic axial spondyloarthritis (nr-axSpA). It is unclear whether current advanced therapies are disease modifying for pulmonary manifestations in patients with axSpA. Prospective studies are warranted to evaluate the efficacy of novel treatments for lung disease in this patient population.