Portuguese recommendations for the use of biological therapies in patients with axial spondyloarthritis -- 2016 update.
Objective: To update the recommendations for the treatment of axial spondyloarthritis (axSpA) with biological therapies, endorsed by the Portuguese Society of Rheumatology. Methods: These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consens...
| Published in: | Acta Reumatológica Portuguesa no. 3; pp. 209 - 219 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
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Sociedade Portuguesa de Reumatologia
jul-set2017
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=125443440&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 125443440 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 0303464X 4Z1D jtl: Acta Reumatológica Portuguesa issn: 0303464X maglogo: N pubinfo: dt: jul-set2017 iid: 3 pid: 38819 pub: Sociedade Portuguesa de Reumatologia artinfo: ui: 125443440 ppf: 209 ppct: 10 formats: fmt: @attributes: type: P size: 586KB tig: atl: Portuguese recommendations for the use of biological therapies in patients with axial spondyloarthritis -- 2016 update. aug: au: Machado, P. M. Cerqueira, M. Ávila-Ribeiro, P. Aguiar, R. Bernardo, A. Sepriano, A. Águeda, A. Cordeiro, A. Raposo, A. Rodrigues, A. M. Barcelos, A. Malcata, A. Lopes, C. Vaz, C. C. Nour, D. Godinho, F. Alvarenga, F. Pimentel-Santos, F. Canhão, H. Santos, H. affil: Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK Rheumatology Department, Unidade Local de Saúde do Alto Minho, Hospital Conde de Bertiandos, Ponte de Lima, Portugal Rheumatology and Metabolic Bone Diseases Department, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal Rheumatology Department, Centro Hospitalar do Baixo Vouga, Hospital de Aveiro, Aveiro, Portugal Rheumatology Department, Centro Hospitalar de S. João, Porto, Portugal NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal Rheumatology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal CEDOC, EpiDoC Unit, NOVA Medical School and National School of Public Health, Universidade Nova de Lisboa, Lisboa, Portugal Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal Rheumatology Department, Centro Hospitalar Lisboa Ocidental, Hospital de Egas Moniz, Lisboa, Portugal Rheumatology Department, Unidade Local de Saúde da Guarda, Guarda, Portugal Clínica Intregare Terapêutica, Fortaleza, Ceará, Brasil Consultório Privado de Reumatologia, Portugal Instituto Português de Reumatologia, Lisboa, Portugal su: Biotherapy Ankylosing spondylitis treatment Rheumatology Antirheumatic agents Adalimumab Societies sug: subj: Biotherapy Ankylosing spondylitis treatment Rheumatology Antirheumatic agents Adalimumab Societies keyword: ankylosing spondylitis axial spondyloarthritis biological therapies guidelines Portugal recommendations ab: Objective: To update the recommendations for the treatment of axial spondyloarthritis (axSpA) with biological therapies, endorsed by the Portuguese Society of Rheumatology. Methods: These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consensus opinion. At a national meeting, the recommendations included in this document were discussed and updated. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication and the level of agreement among Portuguese Rheumatologists was anonymously assessed using an online survey. Results: A consensus was achieved regarding the initiation, assessment of response and switching of biological therapies in patients with axSpA. In total, se ven recommendations were produced. The first recommendation is a general statement indicating that biological therapy is not a first-line drug treatment option and should only be used after conventional treatment has failed. The second recommendation is also a general statement about the broad concept of axSpA adopted by these recommendations that includes both non-radiographic and radiographic axSpA. Recommendations 3 to 7 deal with the definition of active disease (including the recommended threshold of 2.1 for the Ankylosing Spondylitis Disease Activity Score [ASDAS] or the threshold of 4 [0-10 scale] for the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), conventional treatment failure (nonsteroidal anti-inflammatory drugs being the first-line drug treatment), assessment of response to treatment (based on an ASDAS improvement of at least 1.1 units or a BASDAI improvement of at least 2 units [0-10 scale] or at least 50%), and strategy in the presence of an inadequate response (where switching is recommended) or in the presence of long-term remission (where a process of biological therapy optimization can be considered, either a gradual increase in the interval between doses or a decrease of each dose of the biological therapy). Conclusion: These recommendations may be used for guidance in deciding which patients with axSpA should be treated with biological therapies. They cover a rapidly evolving area of therapeutic intervention. As more evidence becomes available and more biological therapies are licensed, these recommendations will have to be updated. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Acta Reumatológica Portuguesa holder: Sociedade Portuguesa de Reumatologia dt: @attributes: year: 2017 holdings: @attributes: islocal: N |
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