Jordi Gratacós1, Petra Díaz Del Campo Fontecha2, Cristina Fernández-Carballido3, Xavier Juanola Roura4, Luis Francisco Linares Ferrando5, Eugenio de Miguel Mendieta6, Santiago Muñoz Fernández7, Jose Luis Rosales-Alexander8, Pedro Zarco Montejo9, Mercedes Guerra Rodríguez2, Victoria Navarro Compán6. 1. Servicio de Reumatología, Hospital Universitario Parc Taulí, I3PT, UAB, Sabadell, Barcelona, España. Electronic address: jgratacosmas@gmail.com. 2. Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. 3. Servicio de Reumatología, Hospital General Universitario de Elda, Elda, Alicante, España. 4. Servicio de Reumatología, Hospital Universitari Bellvitge, Hospitalet de Llobregat, Barcelona, España. 5. Servicio de Reumatología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España. 6. Servicio de Reumatología, Hospital Universitario La Paz, IdiPaz, Madrid, España. 7. Servicio de Reumatología, Hospital Universitario Infanta Sofía, Universidad Europea, San Sebastián de los Reyes, Madrid, España. 8. Servicio de Reumatología, Hospiten Rambla, Santa Cruz de Tenerife, España. 9. Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Abstract
OBJECTIVE: Recent data published on biological therapy in axial spondyloarthritis (axSpA) since the last publication of the recommendations of the Spanish Society of Rheumatology (SER) has led to the generation of a review of these recommendations based on the best possible evidence. These recommendations should be a reference for rheumatologists and those involved in the treatment of patients with axSpA. METHODS: Recommendations were drawn up following a nominal group methodology and based on systematic reviews. The level of evidence and grade of recommendation were classified according to the model proposed by the Centre for Evidence Based Medicine at Oxford. The level of agreement was established through the Delphi technique. RESULTS: In this review, we did an update of the evaluation of disease activity and treatment objectives. We included the new drugs with approved therapeutic indication for axSpA. We reviewed both the predictive factors of the therapeutic response and progression of radiographic damage. Finally, we drafted some recommendations for the treatment of patients refractory to anti-tumor necrosis factor, as well as for the possible optimization of biological therapy. The document also includes a table of recommendations and a treatment algorithm. CONCLUSIONS: We present an update of the SER recommendations for the use of biological therapy in patients with axSpA.
OBJECTIVE: Recent data published on biological therapy in axial spondyloarthritis (axSpA) since the last publication of the recommendations of the Spanish Society of Rheumatology (SER) has led to the generation of a review of these recommendations based on the best possible evidence. These recommendations should be a reference for rheumatologists and those involved in the treatment of patients with axSpA. METHODS: Recommendations were drawn up following a nominal group methodology and based on systematic reviews. The level of evidence and grade of recommendation were classified according to the model proposed by the Centre for Evidence Based Medicine at Oxford. The level of agreement was established through the Delphi technique. RESULTS: In this review, we did an update of the evaluation of disease activity and treatment objectives. We included the new drugs with approved therapeutic indication for axSpA. We reviewed both the predictive factors of the therapeutic response and progression of radiographic damage. Finally, we drafted some recommendations for the treatment of patients refractory to anti-tumornecrosis factor, as well as for the possible optimization of biological therapy. The document also includes a table of recommendations and a treatment algorithm. CONCLUSIONS: We present an update of the SER recommendations for the use of biological therapy in patients with axSpA.
Authors: Manuel José Moreno-Ramos; Carlos Sanchez-Piedra; Olga Martínez-González; Carlos Rodríguez-Lozano; Carolina Pérez-Garcia; Mercedes Freire; Cristina Campos; Rafael Cáliz-Caliz; Jerusalem Calvo; Juan María Blanco-Madrigal; Ana Pérez-Gómez; María José Moreno-Martínez; Luis Linares; Fernando Sánchez-Alonso; Carlos Sastré; Isabel Castrejón Journal: Rheumatol Ther Date: 2022-04-25