ASAS/EULAR recommendations for the management of ankylosing spondylitis

Area of Science:

• Rheumatology
• Clinical Medicine
• Evidence-Based Practice

Background:

• Ankylosing spondylitis (AS) management requires up-to-date, evidence-based guidelines.
• A collaborative effort was initiated by the 'ASsessment in AS' working group and the European League Against Rheumatism.

Purpose of the Study:

• To develop and present 10 key, evidence-based recommendations for the clinical management of ankylosing spondylitis.
• To synthesize scientific evidence and expert opinion for AS treatment strategies.

Main Methods:

• A Delphi process involving 22 experts identified 10 key propositions for AS management.
• Systematic literature searches were conducted to gather evidence on efficacy, safety, and cost-effectiveness.
• Recommendations were formulated based on evidence strength, risk-benefit analysis, and clinical expertise.

Main Results:

• The recommendations encompass pharmacological treatments (NSAIDs, DMARDs, biologics, steroids, analgesics) and non-pharmacological interventions (education, exercise, physiotherapy).
• Eleven interventions for AS treatment were supported by research evidence (categories I-IV).
• The strength of each recommendation varied based on the quality of evidence and expert consensus.

Conclusions:

• Ten key recommendations for ankylosing spondylitis treatment were established through a rigorous evidence and consensus process.
• These guidelines provide a framework for managing AS, integrating research findings with clinical judgment.
• Regular updates are planned to ensure recommendations remain current with new developments in AS management.