ASAS-EULAR recommendations for the management of axial spondyloarthritis

Autor: Ramiro, Sofia, Nikiphorou, Elena, Sepriano, Alexandre, Ortolan, Augusta, Webers, Casper, Baraliakos, Xenofon, Landewe, Robert, Van den Bosch, Filip, Boteva, Boryana, Bremander, Ann, Carron, Philippe, Ciurea, Adrian, van Gaalen, Floris, Geher, Pal, Gensler, Lianne, Hermann, Josef, de Hooge, Manouk, Husakova, Marketa, Kiltz, Uta, Lopez-Medina, Clementina, Machado, Pedro, Marzo-Ortega, Helena, Molto, Anna, Navarro-Compan, Victoria, Nissen, Michael, Pimentel-Santos, Fernando, Poddubnyy, Denis, Proft, Fabian, Rudwaleit, Martin, Telkman, Mark, Zhao, Sizheng, Ziade, Nelly, van der Heijde, Desiree, ARRAY(0xac34db8)
Přispěvatelé: Interne Geneeskunde, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, Clinical Immunology and Rheumatology, AII - Inflammatory diseases
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases, 82(1), 19-34. BMJ Publishing Group
Annals of the Rheumatic Diseases, 82(1). BMJ PUBLISHING GROUP
Annals of the rheumatic diseases, 82(1):A78, 19-34. BMJ Publishing Group
Ramiro, S, Nikiphorou, E, Sepriano, A, Ortolan, A, Webers, C, Baraliakos, X, Landewé, R B M, Van den Bosch, F E, Boteva, B, Bremander, A, Carron, P, Ciurea, A, van Gaalen, F A, Géher, P, Gensler, L, Hermann, J, de Hooge, M, Husakova, M, Kiltz, U, López-Medina, C, Machado, P M, Marzo-Ortega, H, Molto, A, Navarro-Compán, V, Nissen, M J, Pimentel-Santos, F M, Poddubnyy, D, Proft, F, Rudwaleit, M, Telkman, M, Zhao, S S, Ziade, N & van der Heijde, D 2022, ' ASAS-EULAR recommendations for the management of axial spondyloarthritis : 2022 update ', Annals of the Rheumatic Diseases . https://doi.org/10.1136/ard-2022-223296
Zhao, S & et al. 2022, ' ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update ', Annals of the rheumatic diseases, vol. 82, no. 1, pp. 19-34 . https://doi.org/10.1136/ard-2022-223296
ISSN: 0003-4967
DOI: 10.1136/ard-2022-223296
Popis: ObjectivesTo update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA).MethodsFollowing 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.ResultsFive 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.ConclusionsThe 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
Databáze: OpenAIRE
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