Gratacós Jordi, Díaz Del Campo Fontecha Petra, Fernández-Carballido Cristina, Juanola Roura Xavier, Linares Ferrando Luis Francisco, de Miguel Mendieta Eugenio, Muñoz Fernández Santiago, Rosales-Alexander Jose Luis, Zarco Montejo Pedro, Guerra Rodríguez Mercedes, Navarro Compán Victoria
Servicio de Reumatología, Hospital Universitario Parc Taulí, I3PT, UAB, Sabadell, Barcelona, España.
Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España.
Reumatol Clin (Engl Ed). 2018 Nov-Dec;14(6):320-333. doi: 10.1016/j.reuma.2017.08.008. Epub 2017 Oct 16.
Recent data published on biological therapy in axial spondyloarthritis (axSpA) since the last publication of the recommendations of the Spanish Society of Rheumatology (SER) has led to the generation of a review of these recommendations based on the best possible evidence. These recommendations should be a reference for rheumatologists and those involved in the treatment of patients with axSpA.
Recommendations were drawn up following a nominal group methodology and based on systematic reviews. The level of evidence and grade of recommendation were classified according to the model proposed by the Centre for Evidence Based Medicine at Oxford. The level of agreement was established through the Delphi technique.
In this review, we did an update of the evaluation of disease activity and treatment objectives. We included the new drugs with approved therapeutic indication for axSpA. We reviewed both the predictive factors of the therapeutic response and progression of radiographic damage. Finally, we drafted some recommendations for the treatment of patients refractory to anti-tumor necrosis factor, as well as for the possible optimization of biological therapy. The document also includes a table of recommendations and a treatment algorithm.
We present an update of the SER recommendations for the use of biological therapy in patients with axSpA.
自西班牙风湿病学会（SER）上次发布推荐意见以来，有关中轴型脊柱关节炎（axSpA）生物治疗的最新数据促使人们基于尽可能充分的证据对这些推荐意见进行了重新审视。这些推荐意见应成为风湿病学家及参与axSpA患者治疗人员的参考依据。
推荐意见按照名义群体法并基于系统评价制定。证据水平和推荐等级依据牛津循证医学中心提出的模型进行分类。通过德尔菲技术确定共识水平。
在本次综述中，我们对疾病活动度评估和治疗目标进行了更新。我们纳入了具有axSpA批准治疗适应证的新药。我们回顾了治疗反应的预测因素以及影像学损伤的进展情况。最后，我们起草了一些针对抗肿瘤坏死因子治疗无效患者的治疗建议，以及生物治疗可能的优化建议。该文件还包括一个推荐意见表和一个治疗算法。
我们展示了SER关于axSpA患者生物治疗应用推荐意见的更新内容。
