The Italian Society for Rheumatology recommendations for the management of axial spondyloarthritis

Abstract

Over the last few years, the landscape of treatments for axial spondyloarthritis (SpA) has been rapidly evolving, urging international scientific societies to draft or update existing clinical practice guidelines (CPGs) on the management of axial SpA. The Italian Society for Rheumatology (SIR) committed to provide revised and adapted evidence- and expert-based recommendations for the management of patients with axial SpA in Italy. A systematic approach to the adaptation of existing CPGs - the ADAPTE methodology - was adopted to obtain updated recommendations suitable for the Italian context. A systematic literature search was performed in Medline and Embase databases to find international CPGs and consensus statements with recommendations for the management of axial SpA published in the previous five years. A working group composed of rheumatologists with proven experience in the management of axial SpA and methodologists identified the key research questions which guided study selection and data extraction. Guideline quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) II tool. The Italian recommendations were developed by endorsing or adapting and rewording some existing recommendations. The draft of the recommendations was sent to a multidisciplinary group of external reviewers for comment and rating. Six original CPGs were selected and used to create this SIR CPG, which includes a final set of 14 recommendations covering the management of patients with axial SpA across the following domains: assessment, pharmacological and non-pharmacological treatment, and follow-up. The dissemination and implementation of these SIR recommendations are expected to support an evidencebased clinical approach to the management of patients with axial SpA in Italy.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Dougados M, Baeten D. Spondyloarthritis. Lancet 2011; 377: 2127-37. DOI: https://doi.org/10.1016/S0140-6736(11)60071-8

Rudwaleit M, van der Heijde D, Landewe R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009; 68: 777-83. DOI: https://doi.org/10.1136/ard.2009.108233

Rudwaleit M, van der Heijde D, Landewe R, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011; 70: 25-31. DOI: https://doi.org/10.1136/ard.2010.133645

van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984; 27: 361-8. DOI: https://doi.org/10.1002/art.1780270401

Rudwaleit M, Jurik AG, Hermann KG, et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis. 2009; 68: 1520-7. DOI: https://doi.org/10.1136/ard.2009.110767

Neerinckx B, Lories RJ. Structural disease progression in axial spondyloarthritis: still a cause for concern? Curr Rheumatol Rep. 2017; 19: 14. DOI: https://doi.org/10.1007/s11926-017-0639-7

Fervers B, Burgers JS, Voellinger R, Brouwers M, Browman GP, Graham ID, et al. The ADAPTE collaboration. Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilization. BMJ Qual Saf. 2011; 20: 228-36. DOI: https://doi.org/10.1136/bmjqs.2010.043257

Manara M, Ughi N, Ariani A, et al. Providing updated guidelines for the management of rheumatic diseases in Italy with the ADAPTE methodology: a project by the Italian Society for Rheumatology. Reumatismo 2019; 71(S1): 1-4. DOI: https://doi.org/10.4081/reumatismo.2019.1186

Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010; 182: E839-42. DOI: https://doi.org/10.1503/cmaj.090449

Oxford Centre for Evidence-based Medicine. Levels of Evidence; March 2009. Available from: http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/

Brouwers MC, Kerkvliet K, Spithoff K. The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines. BMJ. 2016; 352: i1152. DOI: https://doi.org/10.1136/bmj.i1152

Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol 2019; 71: 1599-1613. DOI: https://doi.org/10.1002/art.41042

van der Heijde D, Ramiro S, Landewé R, et al. 2016 Update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017; 76: 978-91. DOI: https://doi.org/10.1136/annrheumdis-2016-210770

Mandl P, Navarro-Compán V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015; 74: 1327-39. DOI: https://doi.org/10.1136/annrheumdis-2014-206971

National Institute for Health and Care Excellence (UK). Spondyloarthritis in over 16s: diagnosis and management. London: National Institute for Health and Care Excellence (UK); 2017 Feb.

Smolen JS, Schöls M, Braun J, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 Update of Recommendations by an International Task Force. Ann Rheum Dis. 2018; 77: 3-17. DOI: https://doi.org/10.1136/annrheumdis-2017-211734corr1

Tam LS, Wei JC, Aggarwal A, et al. 2018 APLAR axial spondyloarthritis treatment recommendations. Int J Rheum Dis. 2019; 22: 340-56. DOI: https://doi.org/10.1111/1756-185X.13510

Braun J, Baraliakos X, Kiltz U, et al. Classification and diagnosis of axial spondyloarthritis--what is the clinically relevant difference? J Rheumatol. 2015; 42: 31-8. DOI: https://doi.org/10.3899/jrheum.130959

Dougados M, Linden S, Juhlin R, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991; 34: 1218-27. DOI: https://doi.org/10.1002/art.1780341003

Kellgren JH. Diagnostic criteria for population studies. Bull Rheum Dis. 1962; 13: 291-2.

Maksymowych WP, Lambert RG, Østergaard M, et al. MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI Working Group. Ann Rheum Dis. 2019; 78: 1550-8. DOI: https://doi.org/10.1136/annrheumdis-2019-215589

Bray TJP, Jones A, Bennett AN, et al. Recommendations for acquisition and interpretation of MRI of the spine and sacroiliac joints in the diagnosis of axial spondyloarthritis in the UK. Rheumatology (Oxford) 2019; 58: 1831-8. DOI: https://doi.org/10.1093/rheumatology/kez173

Marchesoni A, D’Angelo S, Anzidei M, et al. Radiologist-rheumatologist multidisciplinary approach in the management of axial spondyloarthritis: a Delphi consensus statement. Clin Exp Rheumatol. ??; 37: 575-84.

Wanders A, Heijde DV, Landewé R, et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum. 2005; 52: 1756-65. DOI: https://doi.org/10.1002/art.21054

Sieper J, Listing J, Poddubnyy D, et al. Effect of continuous versus on-demand treatment of ankylosing spondylitis with diclofenac over 2 years on radiographic progression of the spine: results from a randomised multicentre trial (ENRADAS). Ann Rheum Dis. 2016; 75: 1438-43. DOI: https://doi.org/10.1136/annrheumdis-2015-207897

Khanna Sharma S, Kadiyala V, Naidu G, Dhir V. A randomized controlled trial to study the efficacy of sulfasalazine for axial disease in ankylosing spondylitis. Int J Rheum Dis. 2018; 21: 308-14. DOI: https://doi.org/10.1111/1756-185X.13124

van der Heijde D, Deodhar A, Wei JC, et al. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study. Ann Rheum Dis 2017; 76: 1340-7. DOI: https://doi.org/10.1136/annrheumdis-2016-210322

Nuovo Documento Congiunto su norma biologici biosimilari

contenuta nell’art. 1 comma 407 della Legge n. 232/2016 alla luce del Secondo Position Paper AIFA; 4 maggio 2018. Available from: https://www.reumatologia.it/obj/files/Biosimiliari/DocumentoIntersocietario-BIO18.pdf

Lie E, Lindstrom U, Zverkova-Sandstrom T, et al. Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis: results from the Swedish biologics register. Ann Rheum Dis. 2017; 76: 1515-21. DOI: https://doi.org/10.1136/annrheumdis-2016-210931

Dick AD, Tugal-Tutkun I, Foster S, et al. Secukinumab in the treatment of noninfectious uveitis: results of three randomized, controlled clinical trials. Ophthalmology 2013; 120: 777-87. DOI: https://doi.org/10.1016/j.ophtha.2012.09.040

Gao X, Wendling D, Botteman MF, et al. Clinical and economic burden of extra-articular manifestations in ankylosing spondylitis patients treated with anti-tumor necrosis factor agents. J Med Econ. 2012; 15: 1054-63. DOI: https://doi.org/10.3111/13696998.2012.692341

Hueber W, Sands BE, Lewitzky S, et al. Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn’s disease: unexpected results of a randomised, double-blind placebo-controlled trial. Gut. 2012; 61: 1693-700. DOI: https://doi.org/10.1136/gutjnl-2011-301668

Targan SR, Feagan BG, Vermeire S, et al. A randomized, double-blind, placebo-controlled study to evaluate the safety, tolerability, and efficacy of AMG 827 in subjects with moderate to severe Crohn’s disease. Gastroenterology. 2012; 143: e26. DOI: https://doi.org/10.1053/j.gastro.2012.07.084

Parisi S, Bortoluzzi A, Sebastiani GD, et al. The Italian Society for Rheumatology clinical practice guidelines for rheumatoid arthritis. Reumatismo. 2019; 71(S1): 22-49. DOI: https://doi.org/10.4081/reumatismo.2019.1202

Mariette X, Forger F, Abraham B, et al. Lack of placental transfer of certolizumab pegol during pregnancy: results from CRIB, a prospective, postmarketing, pharmacokinetic study. Ann Rheum Dis. 2018; 77: 228-33. DOI: https://doi.org/10.1136/annrheumdis-2017-212196

Clowse ME, Forger F, Hwang C, et al. Minimal to no transfer of certolizumab pegol into breast milk: results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study. Ann Rheum Dis. 2017; 76: 1890-6. DOI: https://doi.org/10.1136/annrheumdis-2017-211384

Olivieri I, Salvarani C, Cantini F, et al. Recommendations for starting anti TNF-alpha in patients with ankylosing spondylitis. Reumatismo. 2003; 55: 220-3. DOI: https://doi.org/10.4081/reumatismo.2003.220

D'Angelo S, Padula A, Nigro A, et al. Italian evidence-based recommendations for the management of ankylosing spondylitis: the 3E Initiative in Rheumatology. Clin Exp Rheumatol. 2008; 26: 1005-11.

Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2016; 68: 282-98. DOI: https://doi.org/10.1002/art.39298

Published
2021-08-03
Info
Issue
Section
Guidelines
Keywords:
Clinical Practice Guideline, axial spondyloarthritis, management, treatment.
Statistics
  • Abstract views: 2397

  • PDF: 243
How to Cite
Manara, M., Prevete, I., Marchesoni, A., D’Angelo, S., Cauli, A., Zanetti, A., Ariani, A., Bortoluzzi, A., Parisi, S., Scirè, C., & Ughi, N. (2021). The Italian Society for Rheumatology recommendations for the management of axial spondyloarthritis. Reumatismo, 73(2), 71-88. https://doi.org/10.4081/reumatismo.2021.1367

Most read articles by the same author(s)