Spondyloarthritis & psoriatic arthritis
The Assessment of SpondyloArthritis International Society (ASAS) Consensus-Based Expert Definition of Difficult-to-Manage, including Treatment-Refractory, Axial Spondyloarthritis
Methodological detailsliterature review and 2-round Delphi process, expert task force including patient representation, ASAS membership endorsement vote
- Literature review and 2-round Delphi process
- Expert task force including patient representation
- ASAS membership endorsement vote
Recommendations
As issued by the authors
D2M axial spondyloarthritis (axSpA): in patients diagnosed with axSpA by the rheumatologist, treatment failure (treatment per ASAS-EULAR recommendations and failure of ≥2 b/tsDMARDs with different mechanisms of action unless contraindicated), suboptimal disease control, and physician or patient acknowledgement of problematic signs/symptoms
Treatment-refractory (TR) axSpA is covered by the D2M definition but requires a history of treatment failure, objective signs of inflammatory activity, and exclusion of noninflammatory reasons for nonresponse
Definition endorsed by ASAS at the annual meeting in January 2024, with 89% votes (109/123) in favour
Original publication
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