TY - JOUR T1 - Initiation of biological agents in patients with ankylosing spondylitis: results of a Delphi study by the ASAS Group JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 812 LP - 816 DO - 10.1136/ard.62.9.812 VL - 62 IS - 9 AU - T Pham AU - D van der Heijde AU - A Calin AU - M A Khan AU - Sj van der Linden AU - N Bellamy AU - M Dougados Y1 - 2003/09/01 UR - http://ard.bmj.com/content/62/9/812.abstract N2 - 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. ER -