SAT0387 “do not do” recommendations in the management of comorbidity in patients with axial spondyloarthritis. gecoax project

Abstract

BackgroundDuring the development of recommendations and implementation aids of the GECOAx project, the importance of avoiding certain situations was highlighted.ObjectivesTo recognize what prescriptions, risk assessments, or preventive strategies are wrong practices and should thus be avoided in clinical practice. To establish not to do recommendations in the management of the comorbidity of AxSpA.MethodsA multidisciplinary group was selected [10 rheumatologists, 1 internist, 1 cardiologist, 1 gastroenterologist, 1 psychologist and 2 family physicians]. With the support of 3 methodologists, and after interactions aimed to edit a document for the management of comorbidity launched by the same panel, a list of Not to do recommendations was issued. In a discussion meeting, evidence was provided to support the recommendations, items without sufficient basis were removed, and the final list was produced.ResultsA summary list of Not to do recommendations (Table 1) was issued.Table 1– DO NOT prescribe NSAIDs to patients with high cardiovascular (CV) risk and particularly with hypertension.– DO NOT prescribe NSAIDs to patients with CKD, heart failure or liver cirrhosis and, if necessary, exert caution.– DO NOT use CV risk scores in patients who already suffered a CV event or those with multiple risk factors (smoking, obesity, sedentary lifestyle, DM, hypertension, dyslipidemia) or a family history of premature CV disease; All should be considered high CV risk.– DO NOT base renal disease screening on a single glomerular filtration test and/or albuminuria (ALWAYS should be confirmed); serum creatinine should not be used as the only test to evaluate renal function.– DO NOT administer biological therapy in case of active, serious and uncontrolled infection, sepsis or risk of sepsis or tuberculosis or without a previous screening of chronic HBV, HCV, HIV and TB.– DO NOT repeat HBV vaccination unless HBV antibody levels are not achieved.– DO NOT vaccinate a patient in therapy with biological agents or in immunosuppressive treatment with live virusesConclusionsThese recommendations aim to avoid making common mistakes in clinical practice and to help better management of frequent comorbidity in patients with AxSpA.AcknowledgementsThis project was funded by Merck Sharp & Dohme Spain. Merck Sharp & Dohme had no influence on either the development of the project or the final content of the manuscript.Disclosure of InterestNone declared