Publication: 2018 APLAR axial spondyloarthritis treatment recommendations
Issued Date
2019-03-01
Resource Type
ISSN
1756185X
17561841
17561841
Other identifier(s)
2-s2.0-85062332373
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Rheumatic Diseases. Vol.22, No.3 (2019), 340-356
Suggested Citation
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 2018 APLAR axial spondyloarthritis treatment recommendations. International Journal of Rheumatic Diseases. Vol.22, No.3 (2019), 340-356. doi:10.1111/1756-185X.13510 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51847
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Title
2018 APLAR axial spondyloarthritis treatment recommendations
Other Contributor(s)
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
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
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.