Lai Shan TamJames Cheng Chung WeiAmita AggarwalHan Joo BaekPeter P. CheungPraveena ChiowchanwisawakitLeonila DansJieruo GuNoboru HaginoMitsumasa KishimotoHeizel Manapat ReyesSoosan SorooshSimon StebbingsSamuel WhittleSwan Sim YeapChak Sing LauThe Third Affiliated Hospital, Sun Yat-sen UniversityAja University of Medical SciencesGachon UniversitySubang Jaya Medical CentreChung Shan Medical University HospitalUniversity of the Philippines ManilaChung Shan Medical UniversityYong Loo Lin School of MedicineSanjay Gandhi Postgraduate Institute of Medical Sciences LucknowSt. Luke’s International UniversityFaculty of Medicine, Siriraj Hospital, Mahidol UniversityDunedin School of MedicineThe University of AdelaideChina Medical University TaichungThe University of Hong KongChinese University of Hong KongChiba University2020-01-272020-01-272019-03-01International Journal of Rheumatic Diseases. Vol.22, No.3 (2019), 340-3561756185X175618412-s2.0-85062332373https://repository.li.mahidol.ac.th/handle/20.500.14594/51847© 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.Mahidol UniversityMedicineArticleSCOPUS10.1111/1756-185X.13510