2024 Thai Rheumatism Association Guideline for the Treatment of Axial Spondyloarthritis with Biologic and Targeted Synthetic Disease-Modifying Anti-Rheumatic Drugs
5
Issued Date
2024-11-01
Resource Type
ISSN
01252208
Scopus ID
2-s2.0-105007290062
Journal Title
Journal of the Medical Association of Thailand
Volume
107
Issue
11
Start Page
930
End Page
944
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.107 No.11 (2024) , 930-944
Suggested Citation
Katchamart W., Aiewruengsurat D., Chaiamnuay S., Chiowchanwisawakit P., Jatuworapruk K., Kasitanon N., Leosuthamas P., Mahakkanukrauh A., Ngamjanyaporn P., Orawongpaisarn A., Pakchotanon R., Pongkulkiat P., Uea-Areewongsa P., Chevaisrakul P., Pisitkun P., Siriwattanakul S., Subphachaisirikul A., Assawasaksakul T., Louthrenoo W., Goo P.A., Kitumnuayong T., Ruksasakul R., Srivorrapattararkul S., Khampaen T., Wangkaew S., O-Charoen P., Surabhakul N., Phumethum V., Suesuwan A., Malaisri P., Manavathongchai S., Hanvivadhanakul P., Ussavasodhi P., Koolvisoot A., Tantiwong P., Onchan T., Panichaporn S., Narongroeknawin P., Asavatanabodee P., Nanagara R., Phutthinart N., Juthong S., Siripaitoon B., Pinyopornpanit V., Angthararak S. 2024 Thai Rheumatism Association Guideline for the Treatment of Axial Spondyloarthritis with Biologic and Targeted Synthetic Disease-Modifying Anti-Rheumatic Drugs. Journal of the Medical Association of Thailand Vol.107 No.11 (2024) , 930-944. 944. doi:10.35755/jmedassocthai.2024.11.930-944-01586 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110649
Title
2024 Thai Rheumatism Association Guideline for the Treatment of Axial Spondyloarthritis with Biologic and Targeted Synthetic Disease-Modifying Anti-Rheumatic Drugs
Author(s)
Katchamart W.
Aiewruengsurat D.
Chaiamnuay S.
Chiowchanwisawakit P.
Jatuworapruk K.
Kasitanon N.
Leosuthamas P.
Mahakkanukrauh A.
Ngamjanyaporn P.
Orawongpaisarn A.
Pakchotanon R.
Pongkulkiat P.
Uea-Areewongsa P.
Chevaisrakul P.
Pisitkun P.
Siriwattanakul S.
Subphachaisirikul A.
Assawasaksakul T.
Louthrenoo W.
Goo P.A.
Kitumnuayong T.
Ruksasakul R.
Srivorrapattararkul S.
Khampaen T.
Wangkaew S.
O-Charoen P.
Surabhakul N.
Phumethum V.
Suesuwan A.
Malaisri P.
Manavathongchai S.
Hanvivadhanakul P.
Ussavasodhi P.
Koolvisoot A.
Tantiwong P.
Onchan T.
Panichaporn S.
Narongroeknawin P.
Asavatanabodee P.
Nanagara R.
Phutthinart N.
Juthong S.
Siripaitoon B.
Pinyopornpanit V.
Angthararak S.
Aiewruengsurat D.
Chaiamnuay S.
Chiowchanwisawakit P.
Jatuworapruk K.
Kasitanon N.
Leosuthamas P.
Mahakkanukrauh A.
Ngamjanyaporn P.
Orawongpaisarn A.
Pakchotanon R.
Pongkulkiat P.
Uea-Areewongsa P.
Chevaisrakul P.
Pisitkun P.
Siriwattanakul S.
Subphachaisirikul A.
Assawasaksakul T.
Louthrenoo W.
Goo P.A.
Kitumnuayong T.
Ruksasakul R.
Srivorrapattararkul S.
Khampaen T.
Wangkaew S.
O-Charoen P.
Surabhakul N.
Phumethum V.
Suesuwan A.
Malaisri P.
Manavathongchai S.
Hanvivadhanakul P.
Ussavasodhi P.
Koolvisoot A.
Tantiwong P.
Onchan T.
Panichaporn S.
Narongroeknawin P.
Asavatanabodee P.
Nanagara R.
Phutthinart N.
Juthong S.
Siripaitoon B.
Pinyopornpanit V.
Angthararak S.
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective: To provide rheumatologists with the decisions for the appropriate and standardized treatment of patients with axial spondyloarthritis (axSpA) with biologic disease-modifying antirheumatic drugs (bDMARD) and targeted synthetic DMARDs (tsDMARD), according to current evidence and expert opinion. Materials and Methods: The development process involved 46 rheumatologist representatives from medical schools, government hospitals, and private hospitals nationwide. Relevant clinical questions related to treatment initiation criteria, administration, evaluation, monitoring, and intensive treatment options were selected. The evidence was systematically identified and summarized. Quality of evidence was evaluated and ranked according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scoring methodology. The recommendations were then proposed and voted on using the nominal group process. The input was collected from stakeholders through a public hearing. The final 13 recommendations were provided. Results: The guideline addresses the criteria for starting bDMARD/tsDMARD and details the first-line drugs for specific disease profiles, including predominantly axial involvement, predominantly peripheral joint involvement, and uveitis. It also addresses the management of patients with comorbid conditions such as tuberculosis, chronic hepatitis B, malignancy, and pregnancy. Additionally, it covers monitoring and follow-up procedures, alternative treatments for first-line treatment failures, tapering treatment after remission, and reinstitution of bDMARD/tsDMARD in case of flare-up. Conclusion: Thai Rheumatism Association has proposed a set of recommendations to outline concepts and provide guidance on the treatment of axSpA with bDMARD and tsDMARD for Thai rheumatologists.