ASAS-EULAR recommendations for the management of axial spondyloarthritis
| Main Author: | |
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| Publication Date: | 2022 |
| Other Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | http://hdl.handle.net/10362/147366 |
Summary: | Funding EULAR and Assessment of SpondyloArthritis international Society (ASAS). |
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ASAS-EULAR recommendations for the management of axial spondyloarthritis2022 updateBiological TherapySpondyloarthritisTherapeuticsRheumatologyImmunology and AllergyImmunologyBiochemistry, Genetics and Molecular Biology(all)Funding EULAR and Assessment of SpondyloArthritis international Society (ASAS).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.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Comprehensive Health Research Centre (CHRC) - pólo NMSRUNRamiro, SofiaNikiphorou, ElenaSepriano, AlexandreOrtolan, AugustaWebers, CasperBaraliakos, XenofonLandewé, Robert B.M.Van Den Bosch, Filip E.Boteva, BoryanaBremander, AnnCarron, PhilippeCiurea, AdrianVan Gaalen, Floris A.Géher, PálGensler, LianneHermann, JosefDe Hooge, ManoukHusakova, MarketaKiltz, UtaLópez-Medina, ClementinaMachado, Pedro M.Marzo-Ortega, HelenaMolto, AnnaNavarro-Compán, VictoriaNissen, Michael J.M. Pimentel-Santos, F.Poddubnyy, DenisProft, FabianRudwaleit, MartinTelkman, MarkZhao, Sizheng StevenZiade, NellyVan Der Heijde, Désirée2023-01-11T22:17:54Z2022-10-212022-10-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/147366eng0003-4967PURE: 47973281https://doi.org/10.1136/ard-2022-223296info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-09-23T01:38:18Zoai:run.unl.pt:10362/147366Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:38:29.030901Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
ASAS-EULAR recommendations for the management of axial spondyloarthritis 2022 update |
| title |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| spellingShingle |
ASAS-EULAR recommendations for the management of axial spondyloarthritis Ramiro, Sofia Biological Therapy Spondyloarthritis Therapeutics Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| title_short |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| title_full |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| title_fullStr |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| title_full_unstemmed |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| title_sort |
ASAS-EULAR recommendations for the management of axial spondyloarthritis |
| author |
Ramiro, Sofia |
| author_facet |
Ramiro, Sofia Nikiphorou, Elena Sepriano, Alexandre Ortolan, Augusta Webers, Casper Baraliakos, Xenofon Landewé, Robert B.M. Van Den Bosch, Filip E. Boteva, Boryana Bremander, Ann Carron, Philippe Ciurea, Adrian Van Gaalen, Floris A. Géher, Pál Gensler, Lianne Hermann, Josef De Hooge, Manouk Husakova, Marketa Kiltz, Uta López-Medina, Clementina Machado, Pedro M. Marzo-Ortega, Helena Molto, Anna Navarro-Compán, Victoria Nissen, Michael J. M. Pimentel-Santos, F. Poddubnyy, Denis Proft, Fabian Rudwaleit, Martin Telkman, Mark Zhao, Sizheng Steven Ziade, Nelly Van Der Heijde, Désirée |
| author_role |
author |
| author2 |
Nikiphorou, Elena Sepriano, Alexandre Ortolan, Augusta Webers, Casper Baraliakos, Xenofon Landewé, Robert B.M. Van Den Bosch, Filip E. Boteva, Boryana Bremander, Ann Carron, Philippe Ciurea, Adrian Van Gaalen, Floris A. Géher, Pál Gensler, Lianne Hermann, Josef De Hooge, Manouk Husakova, Marketa Kiltz, Uta López-Medina, Clementina Machado, Pedro M. Marzo-Ortega, Helena Molto, Anna Navarro-Compán, Victoria Nissen, Michael J. M. Pimentel-Santos, F. Poddubnyy, Denis Proft, Fabian Rudwaleit, Martin Telkman, Mark Zhao, Sizheng Steven Ziade, Nelly Van Der Heijde, Désirée |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Comprehensive Health Research Centre (CHRC) - pólo NMS RUN |
| dc.contributor.author.fl_str_mv |
Ramiro, Sofia Nikiphorou, Elena Sepriano, Alexandre Ortolan, Augusta Webers, Casper Baraliakos, Xenofon Landewé, Robert B.M. Van Den Bosch, Filip E. Boteva, Boryana Bremander, Ann Carron, Philippe Ciurea, Adrian Van Gaalen, Floris A. Géher, Pál Gensler, Lianne Hermann, Josef De Hooge, Manouk Husakova, Marketa Kiltz, Uta López-Medina, Clementina Machado, Pedro M. Marzo-Ortega, Helena Molto, Anna Navarro-Compán, Victoria Nissen, Michael J. M. Pimentel-Santos, F. Poddubnyy, Denis Proft, Fabian Rudwaleit, Martin Telkman, Mark Zhao, Sizheng Steven Ziade, Nelly Van Der Heijde, Désirée |
| dc.subject.por.fl_str_mv |
Biological Therapy Spondyloarthritis Therapeutics Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| topic |
Biological Therapy Spondyloarthritis Therapeutics Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| description |
Funding EULAR and Assessment of SpondyloArthritis international Society (ASAS). |
| publishDate |
2022 |
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2022-10-21 2022-10-21T00:00:00Z 2023-01-11T22:17:54Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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0003-4967 PURE: 47973281 https://doi.org/10.1136/ard-2022-223296 |
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