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ASAS-EULAR recommendations for the management of axial spondyloarthritis

2022-10-21Artigo científico Acesso aberto
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dc.contributor.authorRamiro, Sofia
dc.contributor.authorRamiro, Sofia
dc.contributor.authorNikiphorou, Elena
dc.contributor.authorSepriano, Alexandre
dc.contributor.authorSepriano, Alexandre
dc.contributor.authorOrtolan, Augusta
dc.contributor.authorWebers, Casper
dc.contributor.authorBaraliakos, Xenofon
dc.contributor.authorLandewé, Robert B.M.
dc.contributor.authorVan Den Bosch, Filip E.
dc.contributor.authorBoteva, Boryana
dc.contributor.authorBremander, Ann
dc.contributor.authorCarron, Philippe
dc.contributor.authorCiurea, Adrian
dc.contributor.authorVan Gaalen, Floris A.
dc.contributor.authorGéher, Pál
dc.contributor.authorGensler, Lianne
dc.contributor.authorHermann, Josef
dc.contributor.authorDe Hooge, Manouk
dc.contributor.authorHusakova, Marketa
dc.contributor.authorKiltz, Uta
dc.contributor.authorLópez-Medina, Clementina
dc.contributor.authorMachado, Pedro M.
dc.contributor.authorMarzo-Ortega, Helena
dc.contributor.authorMolto, Anna
dc.contributor.authorNavarro-Compán, Victoria
dc.contributor.authorNissen, Michael J.
dc.contributor.authorPimentel-Santos, Fernando M.
dc.contributor.authorM. Pimentel-Santos, F.
dc.contributor.authorPoddubnyy, Denis
dc.contributor.authorProft, Fabian
dc.contributor.authorRudwaleit, Martin
dc.contributor.authorTelkman, Mark
dc.contributor.authorZhao, Sizheng Steven
dc.contributor.authorZiade, Nelly
dc.contributor.authorVan Der Heijde, Désirée
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblBMJ Publishing Group
dc.date.accessioned2023-01-11T22:17:54Z
dc.date.available2023-01-11T22:17:54Z
dc.date.issued2022-10-21
dc.descriptionFunding EULAR and Assessment of SpondyloArthritis international Society (ASAS).
dc.description.abstractObjectives: 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.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1818463
dc.identifier.doi10.1136/ard-2022-223296
dc.identifier.issn0003-4967
dc.identifier.otherPURE: 47973281
dc.identifier.otherPURE UUID: 150329fa-9b4b-4bd0-bcc2-79f44ee0ca47
dc.identifier.otherScopus: 85142060542
dc.identifier.otherPubMed: 36270658
dc.identifier.otherWOS: 000872150900001
dc.identifier.urihttp://hdl.handle.net/10362/147366
dc.identifier.urlhttps://www.scopus.com/pages/publications/85142060542
dc.language.isoeng
dc.peerreviewedyes
dc.subjectBiological Therapy
dc.subjectSpondyloarthritis
dc.subjectTherapeutics
dc.subjectRheumatology
dc.subjectImmunology and Allergy
dc.subjectImmunology
dc.subjectGeneral Biochemistry,Genetics and Molecular Biology
dc.titleASAS-EULAR recommendations for the management of axial spondyloarthritisen
dc.title.subtitle2022 updateen
dc.typejournal article
degois.publication.firstPage19
degois.publication.issue1
degois.publication.lastPage34
degois.publication.titleAnnals of the rheumatic diseases
degois.publication.volume82
dspace.entity.typePublication
person.familyNameRamiro
person.familyNameSepriano
person.familyNamePimentel-Santos
person.givenNameSofia
person.givenNameAlexandre
person.givenNameFernando
person.identifier397398
person.identifier394707
person.identifier.ciencia-idC513-D4F1-EEC3
person.identifier.ciencia-id5E1B-9976-5CE4
person.identifier.ciencia-idCE12-F61E-3227
person.identifier.orcid0000-0002-8899-9087
person.identifier.orcid0000-0003-1954-0229
person.identifier.orcid0000-0002-2816-7705
person.identifier.scopus-author-id55266526300
person.identifier.scopus-author-id35249227600
rcaap.rightsopenAccess
relation.isAuthorOfPublication9853406a-2641-440d-a8b1-a516bdb6f32f
relation.isAuthorOfPublicationd87df0c7-841b-4648-a99e-296348e2e286
relation.isAuthorOfPublicationdc1c295c-5cad-49f3-9b79-26b1fd03de49
relation.isAuthorOfPublication.latestForDiscoveryd87df0c7-841b-4648-a99e-296348e2e286

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