Remission in axial spondyloarthritis: Developing a consensus definition
Por:
Fernandez C, Collantes-Estévez E, Gratacós J, Juanola X and Zarco P
Publicada:
1 ago 2021
Ahead of Print:
1 jul 2021
Categoría:
Rheumatology
Resumen:
Objective: To reach a consensus on the tools available to evaluate disease activity in patients with axial spondyloarthritis (axSpA), and to develop a consensus definition of remission in axSpA.
Methods: A modified Delphi method was used. A scientific committee proposed statements addressing the assessment of axSpA in clinical practice and the definition of remission. The questionnaire was evaluated in 2 rounds by rheumatologists from GRESSER (GRupo de Estudio de ESpondiloartritis de la Sociedad Espanola de Reumatologia).
Results: After 2 rounds of evaluation, a panel of 81 rheumatologists reached agreement on 56 out of the 80 proposed items (72.0%). There was agreement that the definition of remission in axSpA should include: disease activity, pain, fatigue, peripheral involvement, extra-articular manifestations, laboratory tests, functional impairment, mobility, quality of life, need for treatment, radiographic progression, and patient and physician global assessments. It is recommended to set a therapeutic goal when starting a treatment. The ideal goal is remission although low disease activity may also be an acceptable alternative. The Ankylosing Spondylitis Disease Activity Score (ASDAS) is the preferred tool to assess disease activity. The panel made a proposal for clinical remission in axSpA based on the ASDAS cut-off value for inactive disease, the absence of extra-articular (acute anterior uveitis, psoriasis, inflammatory bowel disease) and peripheral (arthritis, enthesitis, dactylitis) manifestations, plus normal C-reactive protein levels and absence of radiographic progression.
Conclusion: This work offers consensus recommendations and a proposal of clinical remission that maybe useful in the management of patients with axSpA. (C) 2020 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.
Filiaciones:
Fernandez C:
Rheumatology Unit, University Hospital San Juan de Alicante, Alicante, Spain
Collantes-Estévez E:
Department of Rheumatology, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
Gratacós J:
Rheumatology Service, University Hospital Parc Taulí Sabadell, I3PT, UAB, Barcelona, Spain
Juanola X:
Rheumatology Service, University Hospital Bellvitge, IDIBELL, Barcelona, Spain
Zarco P:
Rheumatology Service, University Hospital Fundación Alcorcón, Madrid, Spain
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