What are the American College of Rheumatology treatment guidelines for adults with stable nonradiographic axial spondyloarthritis (SpA)?

Updated: Feb 02, 2021
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In adults with stable nonradiographic axial spondyloarthritis (SpA):

  • Conditionally recommend on-demand treatment with NSAIDs over continuous treatment with NSAIDs
  • In adults receiving treatment with TNFi and NSAIDs, conditionally recommend continuing treatment with TNFi alone over continuing both medications
  • In patients receiving treatment with TNFi and a conventional synthetic antirheumatic drug, conditionally recommend continuing treatment with the TNFi alone over continuing treatment with both medications
  • In patients receiving treatment with a biologic, conditionally recommend against discontinuing it
  • In patients receiving treatment with a biologic, conditionally recommend against tapering of the biologic dose as a standard approach
  • In patients receiving treatment with an originator TNFi, strongly recommend continuation of treatment with the originator TNFi over mandated switching to its biosimilar

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