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 lite - rature evidence and cons...

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Publicado en:Acta Reumatológica Portuguesa Vol. 43; pp. 52 - 62
Autores principales: 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.
Formato: Artículo
Publicado: Sociedade Portuguesa de Reumatologia 2018 Supplement
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Portuguese recommendations for the use of biological therapies in patients with axial spondyloarthritis - 2016 update.
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          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:
        Arthritis diagnosis
        Rheumatology
        Drug administration
        Drug efficacy
        Patient acceptance of health care
        Health outcome assessment
      sug:
        subj:
          Arthritis diagnosis
          Rheumatology
          Drug administration
          Drug efficacy
          Patient acceptance of health care
          Health outcome assessment
      keyword:
        ankylo - sing spondylitis
        axial spondyloarthritis
        biological therapies
        guidelines
        Portugal
        re - commendations
      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 lite - rature 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 ge - neral 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 di - sease (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 ina -dequate response (where switching is recommended) or in the presence of long-term remission (where a process of biological therapy optimization can be consi - dered, either a gradual increase in the interval between doses or a decrease of each dose of the biological the - rapy). Conclusion: These recommendations may be used for guidance in deciding which patients with axSpA should be treated with biological therapies. They co - ver 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
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