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ASAS-EULAR recommen...
ASAS-EULAR recommendations for the management of axial spondyloarthritis : 2022 update
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- Ramiro, Sofia (author)
- Leiden University Medical Centre
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- Nikiphorou, Elena (author)
- Leiden University Medical Centre,King's College London
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- Sepriano, Alexandre (author)
- NOVA University Lisbon,Leiden University Medical Centre
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- Ortolan, Augusta (author)
- University of Padova
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- Webers, Casper (author)
- Maastricht University
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Baraliakos, Xenofon (author)
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- Landewé, Robert B.M. (author)
- Academic Medical Center of University of Amsterdam (AMC)
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- Van Den Bosch, Filip E. (author)
- Ghent University Hospital,Ghent University
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Boteva, Boryana (author)
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- Bremander, Ann (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Spenshults artrit grupp,Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Spenshults arthritis group,Lund University Research Groups,Danish Hospital for Rheumatic Diseases (IRS)
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- Carron, Philippe (author)
- Ghent University Hospital,Ghent University
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- Ciurea, Adrian (author)
- University Hospital of Zurich
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- Van Gaalen, Floris A. (author)
- Leiden University Medical Centre
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- Géher, Pál (author)
- Semmelweis University
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- Gensler, Lianne (author)
- University of California, San Francisco
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- Hermann, Josef (author)
- Medical University of Graz
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- De Hooge, Manouk (author)
- Ghent University
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- Husakova, Marketa (author)
- Charles University in Prague
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Kiltz, Uta (author)
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- López-Medina, Clementina (author)
- Hospital Universitario Reina Sofia
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- Machado, Pedro M. (author)
- University College London,Northwick Park Hospital,University College London Hospital
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- Marzo-Ortega, Helena (author)
- Leeds School of Medicine
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- Molto, Anna (author)
- Cochin Hospital
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- Navarro-Compán, Victoria (author)
- University Hospital La Paz
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- Nissen, Michael J. (author)
- Geneva University Hospital
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- Pimentel-Santos, Fernando M. (author)
- NOVA University Lisbon
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- Poddubnyy, Denis (author)
- Charité - University Medicine Berlin
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- Proft, Fabian (author)
- Charité - University Medicine Berlin
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Rudwaleit, Martin (author)
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Telkman, Mark (author)
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- Zhao, Sizheng Steven (author)
- University of Manchester
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- Ziade, Nelly (author)
- Saint Joseph University
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- Van Der Heijde, Désirée (author)
- Leiden University Medical Centre
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(creator_code:org_t)
- 2022-10-21
- 2022
- English 16 s.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 82:1, s. 19-34
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Objectives To update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA). Methods Following the EULAR Standardised Operating Procedures, two systematic literature reviews were conducted on non-pharmacological and pharmacological treatment of axSpA. In a task force meeting, the evidence was presented, discussed, and overarching principles and recommendations were updated, followed by voting. Results Five overarching principles and 15 recommendations with a focus on personalised medicine were agreed: eight remained unchanged from the previous recommendations; three with minor edits on nomenclature; two with relevant updates (#9, 12); two newly formulated (#10, 11). The first five recommendations focus on treatment target and monitoring, non-pharmacological management and non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice pharmacological treatment. Recommendations 6-8 deal with analgesics and discourage long-term glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for pure axial involvement. Recommendation 9 describes the indication of biological DMARDs (bDMARDs, that is, tumour necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i)) and targeted synthetic DMARDs (tsDMARDs, ie, Janus kinase inhibitors) for patients who have Ankylosing Spondylitis Disease Activity Score ≥2.1 and failed ≥2 NSAIDs and also have either elevated C reactive protein, MRI inflammation of sacroiliac joints or radiographic sacroiliitis. Current practice is to start a TNFi or IL-17i. Recommendation 10 addresses extramusculoskeletal manifestations with TNF monoclonal antibodies preferred for recurrent uveitis or inflammatory bowel disease, and IL-17i for significant psoriasis. Treatment failure should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities (#11). If active axSpA is confirmed, switching to another b/tsDMARD is recommended (#12). Tapering, rather than immediate discontinuation of a bDMARD, can be considered in patients in sustained remission (#13). The last recommendations (#14, 15) deal with surgery and spinal fractures. Conclusions The 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Biological Therapy
- Spondyloarthritis
- Therapeutics
Publication and Content Type
- art (subject category)
- ref (subject category)
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Ramiro, Sofia
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Nikiphorou, Elen ...
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Sepriano, Alexan ...
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Ortolan, Augusta
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Webers, Casper
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Baraliakos, Xeno ...
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show more...
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Landewé, Robert ...
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Van Den Bosch, F ...
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Boteva, Boryana
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Bremander, Ann
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Carron, Philippe
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Ciurea, Adrian
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Van Gaalen, Flor ...
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Géher, Pál
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Gensler, Lianne
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Hermann, Josef
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De Hooge, Manouk
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Husakova, Market ...
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Kiltz, Uta
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López-Medina, Cl ...
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Machado, Pedro M ...
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Marzo-Ortega, He ...
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Molto, Anna
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Navarro-Compán, ...
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Nissen, Michael ...
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Pimentel-Santos, ...
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Poddubnyy, Denis
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Proft, Fabian
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Rudwaleit, Marti ...
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Telkman, Mark
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Zhao, Sizheng St ...
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Ziade, Nelly
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Van Der Heijde, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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Annals of the Rh ...
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Lund University