Article Text
Abstract
Background: There is ample evidence of important symptomatic efficacy of tumour necrosis factor α (TNFα) inhibition in ankylosing spondylitis (AS). Moreover, studies suggest that anti-TNF could be considered as the first disease controlling antirheumatic treatment (DC-ART) for AS.
Objective: To determine precisely which patients with AS are most likely to benefit from anti-TNFα treatment because of the cost and possible long term side effects of such treatment.
Methods: Assessment in Ankylosing Spondylitis (ASAS) members were asked to use a Delphi technique to name the characteristics of patients with AS for whom they would start DC-ART, in three different clinical presentations (isolated axial involvement, peripheral arthritis, enthesitis).
Results: Among the 62 invited ASAS members, more than 50% actively participated in the four phases of definition according to the Delphi technique. For each of the three clinical presentations, a combination of five to six domains was proposed, with an evaluation instrument and a cut off point defining a minimum level of activity for each domain.
Conclusion: This study provides a profile for a patient with AS for considering initiation of biological agents that reflects the opinion of the ASAS members, using a Delphi exercise. Further studies are required to assess their relevance and their consistency with clinical practice.
- ASAS Working Group
- ankylosing spondylitis
- tumour necrosis factor α
- biological agents
- AS, ankylosing spondylitis
- ASAS, ASsessment in Ankylosing Spondylitis
- BASFI, Bath Ankylosing Spondylitis Functional Index
- CRP, C reactive protein
- DC-ART, disease controlling antirheumatic treatment
- ESR, erythrocyte sedimentation rate
- NSAIDs, non-steroidal anti-inflammatory drugs
- TNFα, tumour necrosis factor α
- VAS, visual analogue scale
Statistics from Altmetric.com
- AS, ankylosing spondylitis
- ASAS, ASsessment in Ankylosing Spondylitis
- BASFI, Bath Ankylosing Spondylitis Functional Index
- CRP, C reactive protein
- DC-ART, disease controlling antirheumatic treatment
- ESR, erythrocyte sedimentation rate
- NSAIDs, non-steroidal anti-inflammatory drugs
- TNFα, tumour necrosis factor α
- VAS, visual analogue scale
Footnotes
-
Department and institution to which the work should be attributed: René Descartes University, AP-HP, Rheumatology B Department, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France