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ACR/SPARTAN 2015 Recommendations for Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis

The ACR and SPARTAN (Spondyloarthritis Research and Treatment Network) has worked together to study 57 specific treatment questions regarding AS and SpA.  The following guidelines have recently been published after conducting systematic literature reviews.

  • For patients with active AS, the strong recommendations included: use of nonsteroidal antiinflammatory drugs (NSAIDs); use of tumor necrosis factor inhibitors (TNFi) when activity persists despite NSAID treatment; use of physical therapy; use of hip arthroplasty for patients with advanced hip arthritis; and NOT to use systemic glucocorticoids.
  • Among the conditional recommendations: No particular TNFi was preferred for AS and SpA, except in patients with concomitant inflammatory bowel disease or recurrent iritis, in whom TNFi monoclonal antibodies should be used.
  • In patients with active nonradiographic axial SpA despite treatment with NSAIDs, it conditionally recommends treatment with TNFi.
  • Other recommendations for patients with nonradiographic axial SpA were based on indirect evidence and were the same as for patients with AS.

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Disclosures
The author has no conflicts of interest to disclose related to this subject