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ASAS/EULAR recommendations for the management of ankylosing spondylitis


Zochling, JM and van der Heijde, D and Burgos-Vargas, R and Collantes, E and Davis, JC and Dijkmans, B and Dougados, M and Geher, P and Inman, RD and Kahn, MA and Kvien, TK and Leirisalo-Repo, M and Olivieri, I and Pavelka, K and Sieper, J and Stucki, G and Sturrock, R and van der Linden, S and Wendling, D and Bohm, H and van Royen, BJ and Braun, J, ASAS/EULAR recommendations for the management of ankylosing spondylitis, Annals of The Rheumatic Diseases: The Eular Journal, 65, (4) pp. 442-452. ISSN 0003-4967 (2006) [Refereed Article]

DOI: doi:10.1136/ard.2005.041137


Objective: To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the 'Assessment in AS' international working group and the European League Against Rheumatism. Methods: Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk-benefit trade-off, and clinical expertise. Results: The final recommendations considered the use of non-steroidal anti-inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co-prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non-pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I-IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion. Conclusion: Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Zochling, JM (Dr Jane Zochling)
ID Code:62681
Year Published:2006
Web of Science® Times Cited:496
Deposited By:Menzies Institute for Medical Research
Deposited On:2010-03-17
Last Modified:2011-07-13

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