What are the recommendations of an international task force on treating axial and peripheral spondyloarthritis?

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

Guidelines issued by an international task force on treating axial and peripheral spondyloarthritis to target include the following recommendations [136] :

  • The treatment target should be clinical remission/inactive disease of musculoskeletal (arthritis, dactylitis, enthesitis, axial disease) and extra-articular manifestations.
  • The treatment target should be individualized on the basis of current clinical manifestations, and the treatment modality should be considered when defining the time required to reach the target.
  • Clinical remission/inactive disease is defined as the absence of clinical and laboratory evidence of significant disease activity; low or minimal disease activity may be an alternative treatment target .
  • Disease activity should be measured on the basis of clinical signs and symptoms, and acute phase reactants.
  • Validated measures of musculoskeletal disease activity and assessment of cutaneous and/or other relevant extra-articular manifestations should be used in clinical practice to define the target and to guide treatment decisions; the frequency of the measurements depends on the level of disease activity.
  • In axial spondyloarthritis, the Ankylosing Spondylitis Disease Activity Score (ASDAS) is a preferred measure.
  • The choice of the target and of the disease activity measure should take comorbidities, patient factors, and drug-related risks into account.
  • In addition to clinical and laboratory measures, imaging results may be considered in clinical management.
  • Once the target is achieved, it should ideally be maintained throughout the course of the disease. 
  • The patient should be appropriately informed and involved in the discussions about the treatment target and the risks and benefits of the strategy planned to reach this target.

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