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Review
. 2023 Jul 1;30(3):151-169.
doi: 10.4078/jrd.2023.0025.

Korean treatment recommendations for patients with axial spondyloarthritis

Mi Ryoung Seo  1 , Jina Yeo  1 , Jun Won Park  2 , Yeon-Ah Lee  3 , Ju Ho Lee  4 , Eun Ha Kang  4 , Seon Mi Ji  5 , Seong-Ryul Kwon  6 , Seong-Kyu Kim  7 , Tae-Jong Kim  8 , Tae-Hwan Kim  9 , Hye Won Kim  10 , Min-Chan Park  11 , Kichul Shin  12 , Sang-Hoon Lee  13 , Eun Young Lee  2 , Hoon Suk Cha  14 , Seung Cheol Shim  15 , Youngim Yoon  2 , Seung Ho Lee  16 , Jun Hong Lim  17 , Han Joo Baek  1 ; Korean Society of Spondyloarthritis Research
Affiliations
Review

Korean treatment recommendations for patients with axial spondyloarthritis

Mi Ryoung Seo et al. J Rheum Dis. .

Erratum in

Abstract

We aimed to develop evidence-based recommendations for treating axial spondylarthritis (axSpA) in Korea. The development committee was constructed, key clinical questions were determined, and the evidence was searched through online databases including MEDLINE, Embase, Cochrane, KoreaMed, and KMbase. Systematic literature reviews were conducted, quality of evidence was determined, and draft recommendations were formulated according to the Grading of Recommendations Assessment, Development, and Evaluations methodology. Recommendations that reached 80% consensus among a voting panel were finalized. Three principles and 21 recommendations were determined. Recommendations 1 and 2 pertain to treatment strategies, regular disease status assessment, and rheumatologist-steered multidisciplinary management. Recommendations 3 and 4 strongly recommend patient education, exercise, and smoking cessation. Recommendations 5~12 address pharmacological treatment of active disease using nonsteroidal anti-inflammatory drugs, glucocorticoids, sulfasalazine, biologics, and Janus kinase inhibitors. Recommendations 13~16 address treatment in stable disease. We suggest against spa and acupuncture as therapies (Recommendation 17). Recommendations 18 and 19 pertain to total hip arthroplasty and spinal surgery. Monitoring of comorbidities and drug toxicities are recommended (Recommendations 20 and 21). Recommendations for axSpA treatment in a Korean context were developed based on comprehensive clinical questions and evidence. These are intended to guide best practice in the treatment of axSpA.

Keywords: Ankylosing spondylitis; Axial spondyloarthritis; Recommendations; Treatment.

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Conflict of interest statement

CONFLICT OF INTEREST M.R.S. received unrestricted grants from Hanlim Pharm, and speaker fees from Lilly. Y.A.L. received consulting and/or speaker fees from Astellas, Janssen, Lilly, AbbVie, and unrestricted grants from Celltrion. E.H.K. received unrestricted grants from Celltrion. S.R.K. received consulting and/or speaker fees from Janssen, Novartis, AbbVie, and unrestricted grants from Celltrion. S.K.K. has been an editorial board member since May 2018, but has no role in the decision to publish this article. T.J.K. received consulting and/or speaker fees from Janssen, AbbVie, Pfizer, and Novartis. T.H.K. received consulting and speaker fees from AbbVie, Novartis, Lilly, Janssen, and unrestricted grants from Yuhan Corporation. M.C.P. received consulting and/or speaker fees from Novartis, Lilly, AbbVie, Chong Kun Dang Pharm, JW Pharm, and research grants from Novartis, and has been an editorial board member since June 2014, but has no role in the decision to publish this article. S.H.L. received consulting and/or speaker fees from Novartis, Janssen, Lilly, AbbVie, Celltrion, and unrestricted grants from Celltrion. E.Y.L. received consulting or speaker fees from Lilly, JW Pharm, Novartis, Janssen, Samsung Bioepis and unrestricted grants from Yuhan Corporation. H.S.C. received consulting and/or speaker fees from LG Chem, Yuhan Corporation, AbbVie, Janssen, Novartis, and unrestricted grants from Celltrion. S.C.S. received consulting and/or speaker fees from AbbVie, Pfizer, Celltrion, Novartis, Astellas, JW Pharm, Chong Kun Dang Pharm, Amgen, and Otsuka Pharm. H.J.B. received consulting or speaker fees from Janssen, Astellas, Novartis, AbbVie, JW Pharm, Meranini, and unrestricted grants from Celltrion.

Figures

Fig. 1
Fig. 1
Treatment algorithm based on Korean treatment recommendations for patients with axial spondyloarthritis. GC: glucocorticoid, IBD: inflammatory bowel disease, IL-17: interleukin-17, JAK: Janus kinase, NSAID: non-steroidal anti-inflammatory drug, SSZ: sulfasalazine, TNF: tumor necrosis factor.
See this image and copyright information in PMC

References

    1. Rudwaleit M, Haibel H, Baraliakos X, Listing J, Märker-Hermann E, Zeidler H, et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60:717–27. doi: 10.1002/art.24483. - DOI - PubMed
    1. van der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76:978–91. doi: 10.1136/annrheumdis-2016-210770. - DOI - PubMed
    1. Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2019;71:1599–613. doi: 10.1002/art.41042. - DOI - PMC - PubMed
    1. Tam LS, Wei JC, Aggarwal A, Baek HJ, Cheung PP, Chiowchanwisawakit P, et al. 2018 APLAR axial spondyloarthritis treatment recommendations. Int J Rheum Dis. 2019;22:340–56. doi: 10.1111/1756-185X.13510. - DOI - PubMed
    1. Rohekar S, Chan J, Tse SM, Haroon N, Chandran V, Bessette L, et al. 2014 Update of the Canadian Rheumatology Association/spondyloarthritis research consortium of Canada treatment recommendations for the management of spondyloarthritis. Part I: principles of the management of spondyloarthritis in Canada. J Rheumatol. 2015;42:654–64. doi: 10.3899/jrheum.141000. - DOI - PubMed

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