medwireNews: The ACR, Spondylitis Association of America, and Spondyloarthritis Research and Treatment Network have issued updated recommendations for the treatment of ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (axSpA).
This update of the 2015 guidelines “was primarily motivated by the availability of new treatment options, notably secukinumab, ixekizumab, tofacitinib, and TNFi [tumor necrosis factor inhibitors] biosimilars, for patients with axial SpA,” say the authors.
Michael Ward (National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland, USA) recommend that based on current evidence, nonsteroidal anti-inflammatory drugs and TNF inhibitors “remain the primary classes of medications for the treatment of AS and nonradiographic axial SpA,” while the interleukin-17A inhibitors secukinumab and ixekizumab and the Janus kinase inhibitor tofacitinib are recommended in certain situations.
“Application of these recommendations must be individualized, and requires careful assessment, sound clinical judgment of each patient’s circumstances, and consideration of a patient’s preferences,” say Ward et al.
The guidelines are published simultaneously in Arthritis Care & Research and Arthritis & Rheumatology.
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Arthritis Care Res 2019; doi:10.1002/acr.24025
Arthritis Rheumatol 2019; doi:10.1002/art.41042