Premium
Consensus statement on the investigation and management of non‐radiographic axial spondyloarthritis (nr‐ax S p A )
Author(s) -
Robinson Philip C.,
Bird Paul,
Lim Irwin,
Saad Nivene,
Schachna Lionel,
Taylor Andrew L.,
Whittle Samuel L.,
Brown Matthew A.
Publication year - 2014
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12358
Subject(s) - medicine , axial spondyloarthritis , statement (logic) , radiography , ankylosing spondylitis , family medicine , evidence based medicine , set (abstract data type) , medical physics , physical therapy , alternative medicine , surgery , pathology , sacroiliitis , political science , law , computer science , programming language
Aim Non‐radiographic axial spondyloarthritis (nr‐ax S p A ) is axial inflammatory arthritis where plain radiographic damage is not evident. An unknown proportion of these patients will progress to ankylosing spondylitis ( AS ). The increasing recognition of nr‐axSpA has been greatly assisted by the widespread use of magnetic resonance imaging. The aim of this article was to construct a set of consensus statements based on a literature review to guide investigation and promote best management of nr‐ax S p A . Methods A literature review using M edline was conducted covering the major investigation modalities and treatment options available. A group of rheumatologists and a radiologist with expertise in investigation and management of S p A reviewed the literature and formulated a set of consensus statements. The Grade system encompassing the level of evidence and strength of recommendation was used. The opinion of a patient with nr‐ax S p A and a nurse experienced in the care of SpA patients was also sought and included. Results The literature review found few studies specifically addressing nr‐ax S p A , or if these patients were included, their results were often not separately reported. Fourteen consensus statements covering investigation and management of nr‐ax S p A were formulated. The level of agreement was high and ranged from 8.1 to 9.8. Treatment recommendations vary little with established AS , but this is primarily due to the lack of available evidence on the specific treatment of nr‐ax S p A . Conclusion The consensus statements aim to improve the diagnosis and management of nr‐ax S p A . We aim to raise awareness of this condition by the public and doctors and promote appropriate investigation and management.