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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">ASAS/EULAR recommendations for the management of ankylosing spondylitis</title>
<author><name sortKey="Zochling, J" sort="Zochling, J" uniqKey="Zochling J" first="J" last="Zochling">J. Zochling</name>
</author>
<author><name sortKey="Van Der Heijde, D" sort="Van Der Heijde, D" uniqKey="Van Der Heijde D" first="D" last="Van Der Heijde">D. Van Der Heijde</name>
</author>
<author><name sortKey="Burgos Argas, R" sort="Burgos Argas, R" uniqKey="Burgos Argas R" first="R" last="Burgos-Vargas">R. Burgos-Vargas</name>
</author>
<author><name sortKey="Collantes, E" sort="Collantes, E" uniqKey="Collantes E" first="E" last="Collantes">E. Collantes</name>
</author>
<author><name sortKey="Davis, J C" sort="Davis, J C" uniqKey="Davis J" first="J C" last="Davis">J C Davis</name>
</author>
<author><name sortKey="Dijkmans, B" sort="Dijkmans, B" uniqKey="Dijkmans B" first="B" last="Dijkmans">B. Dijkmans</name>
</author>
<author><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name>
</author>
<author><name sortKey="Geher, P" sort="Geher, P" uniqKey="Geher P" first="P" last="Géher">P. Géher</name>
</author>
<author><name sortKey="Inman, R D" sort="Inman, R D" uniqKey="Inman R" first="R D" last="Inman">R D Inman</name>
</author>
<author><name sortKey="Khan, M A" sort="Khan, M A" uniqKey="Khan M" first="M A" last="Khan">M A Khan</name>
</author>
<author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T K" last="Kvien">T K Kvien</name>
</author>
<author><name sortKey="Leirisalo Epo, M" sort="Leirisalo Epo, M" uniqKey="Leirisalo Epo M" first="M" last="Leirisalo-Repo">M. Leirisalo-Repo</name>
</author>
<author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I" last="Olivieri">I. Olivieri</name>
</author>
<author><name sortKey="Pavelka, K" sort="Pavelka, K" uniqKey="Pavelka K" first="K" last="Pavelka">K. Pavelka</name>
</author>
<author><name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J" last="Sieper">J. Sieper</name>
</author>
<author><name sortKey="Stucki, G" sort="Stucki, G" uniqKey="Stucki G" first="G" last="Stucki">G. Stucki</name>
</author>
<author><name sortKey="Sturrock, R D" sort="Sturrock, R D" uniqKey="Sturrock R" first="R D" last="Sturrock">R D Sturrock</name>
</author>
<author><name sortKey="Van Der Linden, S" sort="Van Der Linden, S" uniqKey="Van Der Linden S" first="S" last="Van Der Linden">S. Van Der Linden</name>
</author>
<author><name sortKey="Wendling, D" sort="Wendling, D" uniqKey="Wendling D" first="D" last="Wendling">D. Wendling</name>
</author>
<author><name sortKey="Bohm, H" sort="Bohm, H" uniqKey="Bohm H" first="H" last="Böhm">H. Böhm</name>
</author>
<author><name sortKey="Van Royen, B J" sort="Van Royen, B J" uniqKey="Van Royen B" first="B J" last="Van Royen">B J Van Royen</name>
</author>
<author><name sortKey="Braun, J" sort="Braun, J" uniqKey="Braun J" first="J" last="Braun">J. Braun</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">16126791</idno>
<idno type="pmc">1798102</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798102</idno>
<idno type="RBID">PMC:1798102</idno>
<idno type="doi">10.1136/ard.2005.041137</idno>
<date when="2005">2005</date>
<idno type="wicri:Area/Pmc/Corpus">000F38</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F38</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">ASAS/EULAR recommendations for the management of ankylosing spondylitis</title>
<author><name sortKey="Zochling, J" sort="Zochling, J" uniqKey="Zochling J" first="J" last="Zochling">J. Zochling</name>
</author>
<author><name sortKey="Van Der Heijde, D" sort="Van Der Heijde, D" uniqKey="Van Der Heijde D" first="D" last="Van Der Heijde">D. Van Der Heijde</name>
</author>
<author><name sortKey="Burgos Argas, R" sort="Burgos Argas, R" uniqKey="Burgos Argas R" first="R" last="Burgos-Vargas">R. Burgos-Vargas</name>
</author>
<author><name sortKey="Collantes, E" sort="Collantes, E" uniqKey="Collantes E" first="E" last="Collantes">E. Collantes</name>
</author>
<author><name sortKey="Davis, J C" sort="Davis, J C" uniqKey="Davis J" first="J C" last="Davis">J C Davis</name>
</author>
<author><name sortKey="Dijkmans, B" sort="Dijkmans, B" uniqKey="Dijkmans B" first="B" last="Dijkmans">B. Dijkmans</name>
</author>
<author><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name>
</author>
<author><name sortKey="Geher, P" sort="Geher, P" uniqKey="Geher P" first="P" last="Géher">P. Géher</name>
</author>
<author><name sortKey="Inman, R D" sort="Inman, R D" uniqKey="Inman R" first="R D" last="Inman">R D Inman</name>
</author>
<author><name sortKey="Khan, M A" sort="Khan, M A" uniqKey="Khan M" first="M A" last="Khan">M A Khan</name>
</author>
<author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T K" last="Kvien">T K Kvien</name>
</author>
<author><name sortKey="Leirisalo Epo, M" sort="Leirisalo Epo, M" uniqKey="Leirisalo Epo M" first="M" last="Leirisalo-Repo">M. Leirisalo-Repo</name>
</author>
<author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I" last="Olivieri">I. Olivieri</name>
</author>
<author><name sortKey="Pavelka, K" sort="Pavelka, K" uniqKey="Pavelka K" first="K" last="Pavelka">K. Pavelka</name>
</author>
<author><name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J" last="Sieper">J. Sieper</name>
</author>
<author><name sortKey="Stucki, G" sort="Stucki, G" uniqKey="Stucki G" first="G" last="Stucki">G. Stucki</name>
</author>
<author><name sortKey="Sturrock, R D" sort="Sturrock, R D" uniqKey="Sturrock R" first="R D" last="Sturrock">R D Sturrock</name>
</author>
<author><name sortKey="Van Der Linden, S" sort="Van Der Linden, S" uniqKey="Van Der Linden S" first="S" last="Van Der Linden">S. Van Der Linden</name>
</author>
<author><name sortKey="Wendling, D" sort="Wendling, D" uniqKey="Wendling D" first="D" last="Wendling">D. Wendling</name>
</author>
<author><name sortKey="Bohm, H" sort="Bohm, H" uniqKey="Bohm H" first="H" last="Böhm">H. Böhm</name>
</author>
<author><name sortKey="Van Royen, B J" sort="Van Royen, B J" uniqKey="Van Royen B" first="B J" last="Van Royen">B J Van Royen</name>
</author>
<author><name sortKey="Braun, J" sort="Braun, J" uniqKey="Braun J" first="J" last="Braun">J. Braun</name>
</author>
</analytic>
<series><title level="j">Annals of the Rheumatic Diseases</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint><date when="2005">2005</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the ‘ASsessment in AS' international working group and the European League Against Rheumatism.</p>
</sec>
<sec><title>Methods</title>
<p>Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk‐benefit trade‐off, and clinical expertise.</p>
</sec>
<sec><title>Results</title>
<p>The final recommendations considered the use of non‐steroidal anti‐inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co‐prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non‐pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I–IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion.</p>
</sec>
<sec><title>Conclusion</title>
<p>Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id>
<journal-title>Annals of the Rheumatic Diseases</journal-title>
<issn pub-type="ppub">0003-4967</issn>
<issn pub-type="epub">1468-2060</issn>
<publisher><publisher-name>BMJ Group</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">16126791</article-id>
<article-id pub-id-type="pmc">1798102</article-id>
<article-id pub-id-type="publisher-id">ar41137</article-id>
<article-id pub-id-type="doi">10.1136/ard.2005.041137</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Extended Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>ASAS/EULAR recommendations for the management of ankylosing spondylitis</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Zochling</surname>
<given-names>J</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>van der Heijde</surname>
<given-names>D</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Burgos‐Vargas</surname>
<given-names>R</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Collantes</surname>
<given-names>E</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Davis</surname>
<given-names>J C</given-names>
<suffix>Jr</suffix>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Dijkmans</surname>
<given-names>B</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Dougados</surname>
<given-names>M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Géher</surname>
<given-names>P</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Inman</surname>
<given-names>R D</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Khan</surname>
<given-names>M A</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Kvien</surname>
<given-names>T K</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Leirisalo‐Repo</surname>
<given-names>M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Olivieri</surname>
<given-names>I</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Pavelka</surname>
<given-names>K</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Sieper</surname>
<given-names>J</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Stucki</surname>
<given-names>G</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Sturrock</surname>
<given-names>R D</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>van der Linden</surname>
<given-names>S</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Wendling</surname>
<given-names>D</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Böhm</surname>
<given-names>H</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>van Royen</surname>
<given-names>B J</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Braun</surname>
<given-names>J</given-names>
</name>
</contrib>
</contrib-group>
<aff><bold>J Zochling</bold>
, Rheumazentrum‐Ruhrgebiet, St Josefs‐Krankenhaus, Herne, Germany, and Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, Australia</aff>
<aff><bold>D van der Heijde</bold>
,<bold>S van der Linden</bold>
, Department of Internal Medicine, Division of Rheumatology, University Hospital Maastrict and Caphri Research Institute, The Netherlands</aff>
<aff><bold>R Burgos‐Vargas</bold>
, Department of Rheumatology, Hospital General de Mexico, Mexico</aff>
<aff><bold>E Collantes</bold>
, Servicio de Reumatologia, Hospital Reina Sofia, Cordoba, Spain</aff>
<aff><bold>J C Davis, Jr</bold>
, Division of Rheumatology, University of California San Francisco, San Francisco, USA</aff>
<aff><bold>B Dijkmans</bold>
, Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands</aff>
<aff><bold>M Dougados</bold>
, Service de Rheumatologie B, Hospital Cochin, Paris, France</aff>
<aff><bold>P Géher</bold>
, Department of Rheumatology and Physiotherapy, Semmelweis University, Budapest, Hungary</aff>
<aff><bold>R D Inman</bold>
, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada</aff>
<aff><bold>M A Khan</bold>
, Case Western Reserve University, University, MetroHealth Medical Center, Division of Rheumatology, Cleveland, Ohio, USA</aff>
<aff><bold>T K Kvien</bold>
, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway</aff>
<aff><bold>M Leirisalo‐Repo</bold>
, Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, Helsinki, Finland</aff>
<aff><bold>I Olivieri</bold>
, Rheumatology Department of Lucania, S Carlo Hospital, Potenza and Madonna delle Grazie Hospital, Matera, Italy</aff>
<aff><bold>K Pavelka</bold>
, Institute of Rheumatology, Prague, Czech Republic</aff>
<aff><bold>J Sieper</bold>
, Department of Gastroenterology and Rheumatology, Charitè, Campus Benjamin Franklin, Berlin, Germany</aff>
<aff><bold>G Stucki</bold>
, Department of Physical Medicine and Rehabilitation, Ludwig‐Maximilians‐University, Munich, Germany</aff>
<aff><bold>R D Sturrock</bold>
, Centre for Rheumatic Diseases, University Department of Medicine, Glasgow Royal Infirmary, Glasgow, UK</aff>
<aff><bold>D Wendling</bold>
, Service de Rhumatologie, CHU Jean Minjoz, Besancon, France</aff>
<aff><bold>H Böhm</bold>
, Department for Orthopaedics, Spinal Surgery and Paraplegiology, Zentralklinik Bad Berka, Bad Berka, Germany</aff>
<aff><bold>B J van Royen</bold>
, Department of Orthopaedic Surgery, VU University Medical Centre, Amsterdam, The Netherlands</aff>
<aff><bold>J Braun</bold>
, Bochum University, Rheumazentrum‐Ruhrgebiet, St Josefs‐Krankenhaus, Herne, Germany</aff>
<author-notes><corresp>Correspondence to: Professor J Braun<break></break>
Rheumazentrum‐Ruhrgebiet, St Josefs‐Krankenhaus, Landgrafenstr 15, 44652 Herne, Germany; J.Braun@rheumazentrum‐ruhrgebiet.de</corresp>
<fn><p>Copyright © 2006 BMJ Publishing Group Ltd & European League Against Rheumatism</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>4</month>
<year>2006</year>
</pub-date>
<pub-date pub-type="epub"><day>26</day>
<month>8</month>
<year>2005</year>
</pub-date>
<volume>65</volume>
<issue>4</issue>
<fpage>442</fpage>
<lpage>452</lpage>
<history><date date-type="accepted"><day>22</day>
<month>8</month>
<year>2005</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2006 BMJ Publishing Group Ltd & European League Against Rheumatism</copyright-statement>
</permissions>
<abstract><sec><title>Objective</title>
<p>To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the ‘ASsessment in AS' international working group and the European League Against Rheumatism.</p>
</sec>
<sec><title>Methods</title>
<p>Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk‐benefit trade‐off, and clinical expertise.</p>
</sec>
<sec><title>Results</title>
<p>The final recommendations considered the use of non‐steroidal anti‐inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co‐prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non‐pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I–IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion.</p>
</sec>
<sec><title>Conclusion</title>
<p>Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.</p>
</sec>
</abstract>
<kwd-group><kwd>ankylosing spondylitis</kwd>
<kwd>management</kwd>
<kwd>recommendations</kwd>
<kwd>evidence based medicine</kwd>
<kwd>spondyloarthropathies</kwd>
<kwd>ASAS</kwd>
<kwd>EULAR</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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