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Title: 2018 APLAR axial spondyloarthritis treatment recommendations
Authors: Lai Shan Tam
James Cheng Chung Wei
Amita Aggarwal
Han Joo Baek
Peter P. Cheung
Praveena Chiowchanwisawakit
Leonila Dans
Jieruo Gu
Noboru Hagino
Mitsumasa Kishimoto
Heizel Manapat Reyes
Soosan Soroosh
Simon Stebbings
Samuel Whittle
Swan Sim Yeap
Chak Sing Lau
The Third Affiliated Hospital, Sun Yat-sen University
Aja University of Medical Sciences
Gachon University
Subang Jaya Medical Centre
Chung Shan Medical University Hospital
University of the Philippines Manila
Chung Shan Medical University
Yong Loo Lin School of Medicine
Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow
St. Luke’s International University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Dunedin School of Medicine
The University of Adelaide
China Medical University Taichung
The University of Hong Kong
Chinese University of Hong Kong
Chiba University
Keywords: Medicine
Issue Date: 1-Mar-2019
Citation: International Journal of Rheumatic Diseases. Vol.22, No.3 (2019), 340-356
Abstract: © 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd Introduction: Despite the availability of axial spondyloarthritis (SpA) recommendations proposed by various rheumatology societies, we considered that a region-specific guideline was of substantial added value to clinicians of the Asia-Pacific region, given the wide variations in predisposition to infections and other patient factors, local practice patterns, and access to treatment across countries. Materials and methods: Systematic reviews were undertaken of English-language articles published between 2000 and 2016, identified from MEDLINE using PubMed, EMBASE and Cochrane databases. The strength of available evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Recommendations were developed through consensus using the Delphi technique. Results: Fourteen axial SpA treatment recommendations were developed based on evidence summaries and consensus. The first 2 recommendations cover non-pharmacological approaches to management. Recommendations 3 to 5 describe the following: the use of non-steroidal anti-inflammatory drugs as first-line symptomatic treatment; the avoidance of long-term corticosteroid use; and the utility of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) for peripheral or extra-articular manifestations. Recommendation 6 refers to the indications for biological DMARDs (bDMARDs). Recommendation 7 deals specifically with screening for infections endemic to Asia, prior to use of bDMARDs. Recommendations 7 to 13 cover the role of bDMARDs in the treatment of active axial SpA and include related issues such as continuing therapy and use in special populations. Recommendation 14 deals with the utility of surgical intervention in axial SpA. Conclusion: These recommendations provide up-to-date guidance for treatment of axial SpA to help meet the needs of patients and clinicians in the Asia-Pacific region.
ISSN: 1756185X
Appears in Collections:Scopus 2019

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