Taiwan Rheumatology Association consensus recommendations for the management of axial spondyloarthritis

James Cheng-Chung Wei^{1

2}, Chin-Hsiu Liu^{3

4}, Jui-Cheng Tseng⁵, Lin-Fen Hsieh^{6

7}, Chun-Hsiung Chen³, Hsin-Hua Chen⁸, Hung-An Chen⁹, Ying-Chou Chen¹⁰, Chung-Tei Chou¹¹, Hsien-Tzung Liao¹¹, Yi-Chun Lin¹², Shue-Fen Luo¹³, Deng-Ho Yang^{14

15

16}, Kai-Jieh Yeo¹⁷, Wen-Chan Tsai^{18

19}; Taiwan Rheumatology Association (TRA)

Affiliations

¹ Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
² Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
³ Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
⁴ School of Medicine, Tzu Chi University, Hualien, Taiwan.
⁵ Division of Allergy, Immunology, and Rheumatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁶ Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
⁷ School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁸ Division of Allergy-Immunology-Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.
⁹ Department of Allergy, Immunology, and Rheumatology, Chi Mei Medical Center, Tainan, Taiwan.
¹⁰ Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
¹¹ Division of Allergy, Immunology, Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
¹² Department of Allergy, Immunology, and Rheumatology, Cheng Hsin General Hospital, Taipei, Taiwan.
¹³ Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan.
¹⁴ Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung, Taiwan.
¹⁵ Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
¹⁶ Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
¹⁷ Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan.
¹⁸ Division of Allergy, Immunology, and Rheumatology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
¹⁹ Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.

PMID: 31777200
PMCID: PMC7004149
DOI: 10.1111/1756-185X.13752

Review

Taiwan Rheumatology Association consensus recommendations for the management of axial spondyloarthritis

James Cheng-Chung Wei et al. Int J Rheum Dis. 2020 Jan.

. 2020 Jan;23(1):7-23.

doi: 10.1111/1756-185X.13752. Epub 2019 Nov 27.

Authors

Affiliations

¹ Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
² Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
³ Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
⁴ School of Medicine, Tzu Chi University, Hualien, Taiwan.
⁵ Division of Allergy, Immunology, and Rheumatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁶ Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
⁷ School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁸ Division of Allergy-Immunology-Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.
⁹ Department of Allergy, Immunology, and Rheumatology, Chi Mei Medical Center, Tainan, Taiwan.
¹⁰ Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
¹¹ Division of Allergy, Immunology, Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
¹² Department of Allergy, Immunology, and Rheumatology, Cheng Hsin General Hospital, Taipei, Taiwan.
¹³ Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan.
¹⁴ Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung, Taiwan.
¹⁵ Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
¹⁶ Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
¹⁷ Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan.
¹⁸ Division of Allergy, Immunology, and Rheumatology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
¹⁹ Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.

PMID: 31777200
PMCID: PMC7004149
DOI: 10.1111/1756-185X.13752

Abstract

Aim: To establish guidelines for the clinical management of axial spondyloarthritis that take into account local issues and clinical practice concerns for Taiwan.

Method: Overarching principles and recommendations were established by consensus among a panel of rheumatology and rehabilitation experts, based on analysis of the most up-to-date clinical evidence and the clinical experience of panelists. All Overarching Principles and Recommendations were graded according to the standards developed by the Oxford Centre for Evidence Based Medicine, and further evaluated and modified using the Delphi method.

Results: The guidelines specifically address issues such as local medical considerations, National Health Insurance reimbursement, and management of extra-articular manifestations.

Conclusion: It is hoped that this will help to optimize clinical management outcomes for axial spondyloarthritis in Taiwan.

Keywords: IL-17 inhibitor; TNF inhibitor; ankylosing spondylitis; axial spondyloarthritis; extra-articular manifestation; non-radiographic axial spondyloarthritis; spinal fracture.

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Figures

**Figure 1**
Management algorithm for axSpA

See this image and copyright information in PMC

References

1. van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS‐EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76:978‐991. - PubMed
1. Smolen JS, Schöls M, Braun J, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. 2018;77:3‐17. - PMC - PubMed
1. McAllister K, Goodson N, Warburton L, et al. Spondyloarthritis: diagnosis and management: summary of NICE guidance. BMJ. 2017;356:j839. - PubMed
1. Hamilton L, Barkham N, Bhalla A, et al. BSR and BHPR guideline for the treatment of axial spondyloarthritis (including ankylosing spondylitis) with biologics. Rheumatology (Oxford). 2017;56:313‐316. - PubMed
1. Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2016;68:282‐298. - PMC - PubMed

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Taiwan Rheumatology Association consensus recommendations for the management of axial spondyloarthritis

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Taiwan Rheumatology Association consensus recommendations for the management of axial spondyloarthritis

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