Lai Shan Tam1, James Cheng-Chung Wei2,3,4, Amita Aggarwal5, Han Joo Baek6, Peter P Cheung7, Praveena Chiowchanwisawakit8, Leonila Dans9, Jieruo Gu10, Noboru Hagino11, Mitsumasa Kishimoto12, Heizel Manapat Reyes13, Soosan Soroosh14, Simon Stebbings15, Samuel Whittle16, Swan Sim Yeap17, Chak Sing Lau18. 1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong. 2. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. 3. Department of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. 4. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. 5. Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. 6. Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. 7. Division of Rheumatology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore. 8. Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 9. Department of Pediatrics and Clinical Epidemiology, Philippine General Hospital, University of the Philippines, Manila, Philippines. 10. Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 11. Division of Hematology and Rheumatology, Teikyo University Chiba Medical Center, Chiba, Japan. 12. Immuno-Rheumatology Center, St Luke`s International Hospital, St Luke`s International University, Tokyo, Japan. 13. Division of Rheumatology, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines. 14. AJA University of Medical Sciences, Rheumatology Research Center, Tehran, Iran. 15. Department of Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. 16. The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia. 17. Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Malaysia. 18. Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Abstract
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.
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.
Authors: Tae-Han Lee; Bon San Koo; Bora Nam; Ji Seon Oh; Seo Young Park; Seunghun Lee; Kyung Bin Joo; Tae-Hwan Kim Journal: Ther Adv Musculoskelet Dis Date: 2020-11-28 Impact factor: 5.346
Authors: Victoria Navarro-Compán; James Cheng-Chung Wei; Filip Van den Bosch; Marina Magrey; Lisy Wang; Dona Fleishaker; Joseph C Cappelleri; Cunshan Wang; Joseph Wu; Oluwaseyi Dina; Lara Fallon; Vibeke Strand Journal: RMD Open Date: 2022-06
Authors: Mi Ryoung Seo; Ji-Won Kim; Eun-Jung Park; Seung Min Jung; Yoon-Kyoung Sung; Hyungjin Kim; Gunwoo Kim; Hyun-Sook Kim; Myeung-Su Lee; Jisoo Lee; Ji An Hur; Bum Sik Chin; Joong Sik Eom; Han Joo Baek Journal: Korean J Intern Med Date: 2020-09-15 Impact factor: 2.884