Recommendations by the Spanish Society of Rheumatology on the Use of Biological Therapies in Axial Spondyloarthritis

Gratacós, Jordi; Fontecha, Petra Díaz del Campo; Fernández‐Carballido, Cristina; Roura, Xavier; Ferrando, Luis Francisco Linares; Mendieta, Eugenio de Miguel; Fernández, Santiago Muñoz; Rosales-Alexander, José Luis; Montejo, Pedro Zarco; Guerra, Mercedes; Compañ, Victoria

doi:10.1016/j.reumae.2017.08.004

Cited by 9 publications

(14 citation statements)

References 114 publications

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“…On the basis of this scale, several international and national guidelines advocate treatment to the target of achieving clinical remission (ASDAS \ 1.3) or at least low disease activity (ASDAS \ 2.1) [7,38,39]. The ASDAS cutoff for minimal clinically important improvement between examinations is 1.1 or higher, and a change at least 2.0 units is considered a major improvement [36].…”

Section: Disease Activity Measures In Axial Spamentioning

confidence: 99%

Treatment Failure in Axial Spondyloarthritis: Insights for a Standardized Definition

et al. 2022

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Axial spondyloarthritis is a chronic inflammatory rheumatic disease that affects the axial skeleton and causes severe pain and disability. It may be also associated with extra-articular manifestations. Early diagnosis and appropriate treatment can reduce the severity of the disease and the risk of progression. The biological disease-modifying antirheumatic drugs (bDMARDs) tumor necrosis factor alpha (TNFa) inhibitors (TNFi) and the anti-interleukin (IL)-

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Section: Disease Activity Measures In Axial Spamentioning

confidence: 99%

Treatment Failure in Axial Spondyloarthritis: Insights for a Standardized Definition

et al. 2022

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“…Included patients fulfilled the Assessment of Spondyloarthritis International Society (ASAS) [12] classification criteria or the Classification Criteria for Psoriatic Arthritis (CASPAR) [13]. Cohort A (n = 36): Patients with axSpA or PsA active disease (defined as those who were going to start biological therapy or switch to another biologic according to physician criteria and in agreement with clinical guidelines [14,15]). Cohort B (n = 28): Consecutive non-selected PsA patients with active peripheral arthritis defined by clinical examination by a doctor.…”

Section: Methodsmentioning

confidence: 99%

Doppler enthesitis: a potential useful outcome in the assessment of axial spondyloarthritis and psoriatic arthritis

et al. 2020

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Objective To analyse the frequency of power Doppler (PD) enthesitis in active axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients and its potential usefulness in clinical practice. Methods A prospective multicentre cross-sectional study in patients with axSpA and PsA with active disease was undertaken. Patients underwent bilateral ultrasound (US) examination of the peripheral entheses according to the Madrid Sonographic Enthesis Index (MASEI). The MASEI and Outcome Measures in Rheumatology (OMERACT) PD enthesitis definitions were checked. An inter-reader analysis of recorded videos was performed to determine reliability. Results Sixty-four consecutive patients were included. The mean DAS28 (3.9 ± 1.3) for peripheral involvement, mean BASDAI (5.6 ± 2.2) for axial involvement, and CRP values (10 ± 10.9) reflected moderate-high disease activity at baseline. The mean global MASEI score was 29.4 (± 11.4), and 55 patients (86%) scored ≥ 18 (proposed cut-off point to diagnose SpA). At the patient level, abnormal US findings consistent with at least one enthesis showing a PD signal were observed in 52 (81.3%) patients using the MASEI PD definition and 48 (75%) using the OMERACT PD definition, without significant variation between axSpA and PsA. The inter-reader reliability was excellent (kappa = 0.92 for MASEI PD and 0.86 for OMERACT PD). Conclusions PD enthesitis was found in the majority of patients with active axSpA and PsA, independent of axial or peripheral affectation. Both MASEI and OMERACT PD definitions were useful in detecting active enthesitis. These findings support the usefulness of a PD US evaluation of entheses in the assessment of axSpA and PsA.

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“…Patients in the registry were followed up for a 3-year period in which they underwent clinical and laboratory controls every 6 months. Criteria for starting TNFi therapy was made according to the recommendations of the Spanish Society of Rheumatology [13]. The register and subsidiary efficacy and safety analyses complied with the Declaration of Helsinki and were approved by the Ethical Review Boards of all participating hospitals, and patients signed an informed consent form to be included.…”

Section: Patients and Study Designmentioning

confidence: 99%

Sustained low disease activity measured by ASDAS slow radiographic spinal progression in axial spondyloarthritis patients treated with TNF-inhibitors: data from REGISPONSERBIO

et al. 2022

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Background To evaluate the influence of the disease activity on radiographic progression in axial spondyloarthritis (axSpA) patients treated with TNF inhibitors (TNFi). Methods The study included 101 axSpA patients from the Spanish Register of Biological Therapy in Spondyloarthritides (REGISPONSERBIO), which had clinical data and radiographic assessment available. Patients were classified into 2 groups based on the duration of TNFi treatment at baseline: (i) long-term treatment (≥4 years) and (ii) no long-term treatment (< 4 years). Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. Disease activity differences between patients’ groups at each time point were assessed using a linear mixed-effect model. Results Radiographic progression was defined as an increase in ≥2 mSASSS units. At inclusion, approximately half of the patients (45.5%) were receiving long-term treatment with TNFi (≥4 years). In this group of subjects, a significant difference in averaged Ankylosing Spondylitis disease Activity Score (ASDAS) across follow-up was found between progressors and non-progressors (2.33 vs 1.76, p=0.027, respectively). In patients not under long-term TNFi treatment (54.5%) though, no significant ASDAS differences were observed between progressors and non-progressors until the third year of follow-up. Furthermore, no significant differences were found in progression status, when disease activity was measured by Bath Ankylosing spondylitis Disease Activity Index (BASDAI) and C reactive protein (CRP). Conclusions Patients on long-term TNFi treatment with a mean sustained low disease activity measures by ASDAS presented lower radiographic progression than those with active disease.

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Recommendations by the Spanish Society of Rheumatology on the Use of Biological Therapies in Axial Spondyloarthritis

Cited by 9 publications

References 114 publications

Treatment Failure in Axial Spondyloarthritis: Insights for a Standardized Definition

Treatment Failure in Axial Spondyloarthritis: Insights for a Standardized Definition

Doppler enthesitis: a potential useful outcome in the assessment of axial spondyloarthritis and psoriatic arthritis

Sustained low disease activity measured by ASDAS slow radiographic spinal progression in axial spondyloarthritis patients treated with TNF-inhibitors: data from REGISPONSERBIO

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