RT Journal Article
T1 ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update.
A1 Ramiro, Sofia
A1 Nikiphorou, Elena
A1 Sepriano, Alexandre
A1 Ortolan, Augusta
A1 Webers, Casper
A1 Baraliakos, Xenofon
A1 Landewe, Robert B M
A1 Van den Bosch, Filip E
A1 Boteva, Boryana
A1 Bremander, Ann
A1 Carron, Philippe
A1 Ciurea, Adrian
A1 van Gaalen, Floris A
A1 Geher, Pal
A1 Gensler, Lianne
A1 Hermann, Josef
A1 de Hooge, Manouk
A1 Husakova, Marketa
A1 Kiltz, Uta
A1 Lopez-Medina, Clementina
A1 Machado, Pedro M
A1 Marzo-Ortega, Helena
A1 Molto, Anna
A1 Navarro-Compan, Victoria
A1 Nissen, Michael J
A1 Pimentel-Santos, Fernando M
A1 Poddubnyy, Denis
A1 Proft, Fabian
A1 Rudwaleit, Martin
A1 Telkman, Mark
A1 Zhao, Sizheng Steven
A1 Ziade, Nelly
A1 van der Heijde, Desiree
K1 Biological therapy
K1 Spondyloarthritis
K1 Therapeutics
AB To update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA). Following the EULAR Standardised Operating Procedures, two systematic literature reviews were conducted on non-pharmacological and pharmacological treatment of axSpA. In a task force meeting, the evidence was presented, discussed, and overarching principles and recommendations were updated, followed by voting. Five overarching principles and 15 recommendations with a focus on personalised medicine were agreed: eight remained unchanged from the previous recommendations; three with minor edits on nomenclature; two with relevant updates (#9, 12); two newly formulated (#10, 11). The first five recommendations focus on treatment target and monitoring, non-pharmacological management and non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice pharmacological treatment. Recommendations 6-8 deal with analgesics and discourage long-term glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for pure axial involvement. Recommendation 9 describes the indication of biological DMARDs (bDMARDs, that is, tumour necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i)) and targeted synthetic DMARDs (tsDMARDs, ie, Janus kinase inhibitors) for patients who have Ankylosing Spondylitis Disease Activity Score ≥2.1 and failed ≥2 NSAIDs and also have either elevated C reactive protein, MRI inflammation of sacroiliac joints or radiographic sacroiliitis. Current practice is to start a TNFi or IL-17i. Recommendation 10 addresses extramusculoskeletal manifestations with TNF monoclonal antibodies preferred for recurrent uveitis or inflammatory bowel disease, and IL-17i for significant psoriasis. Treatment failure should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities (#11). If active axSpA is confirmed, switching to another b/tsDMARD is recommended (#12). Tapering, rather than immediate discontinuation of a bDMARD, can be considered in patients in sustained remission (#13). The last recommendations (#14, 15) deal with surgery and spinal fractures. The 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
PB BMJ Group
YR 2022
FD 2022-10-04
LK http://hdl.handle.net/10668/20132
UL http://hdl.handle.net/10668/20132
LA en
NO Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al.  ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023 Jan;82(1):19-34
DS RISalud
RD Apr 10, 2025