What are the American College of Rheumatology guidelines for assessment of nonradiographic axial spondyloarthritis (SpA) disease activity, imaging, and screening?

Updated: Feb 02, 2021
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Assessment of disease activity and imaging:

  • Conditionally recommend monitoring of a validated AS disease activity measure at regular intervals
  • Conditionally recommend regular monitoring of the CRP concentrations or ESR over usual care without regular CRP or ESR monitoring
  • In adults with active nonradiographic axial SpA, conditionally recommend against using a treat-to-target strategy using a target of ASDAS < 1.3 (or 2.1) over a treatment strategy based on physician assessment
  • In adults with nonradiographic axial SpA of unclear activity while on a biologic, conditionally recommend obtaining a pelvis MRI to assess activity
  • In adults with stable nonradiographic axial SpA, conditionally recommend against obtaining a spinal or pelvis MRI to confirm inactivity
  • In adults with active or stable nonradiographic axial SpA on any treatment, conditionally recommend against obtaining repeat spine radiographs at a scheduled interval (eg, every 2 years) as a standard approach

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