Argentine guidelines for clinical practice, diagnosis, evaluation and treatment in adult patients with axial spondyloarthritis

Autores: María Victoria Martire, Mariana Benegas, Carla Airoldi, Natalia Zamora, Gustavo Citera, Enrique Soriano, Emilio Buschiazzo, Dafne Capelusnik, Tomás Cazenave, Vanesa Cosentino, Leandro Ferreyra Garrot, Rodrigo García Salinas, Carolina Isnardi, Maximiliano Machado Escobar, José Maldonado Cocco, Hernán Maldonado Fico, Josefina Marin, Romina Nieto, Rodolfo Pérez Alamino, Javier Eduardo Rosa, Fernando Sommerfleck, Diego Vila, Diana Fernández, Emilce E. Schneeberger

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Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that includes radiographic spondyloarthritis (r-axSpA) (previously known as ankylosing spondylitis [AS]) and non-radiographic axial spondyloarthritis (nr-axSpondyloarthritis). Patients with nr-axSpA may have spinal inflammatory involvement detected by magnetic resonance imaging (MRI) but, unlike patients with AS, do not have evidence of sufficient radiographic structural damage to meet the modified New York criteria. Both phenotypes generate a significant impact on quality of life, overall health status, and work productivity if they are not treated in a timely and adequate manner.Although there are treatment guidelines for AxSpA, such as those of the American College of Rheumatology/Spondyloarthritis Research and Treatment Network (ACR/SPARTAN), the Panamerican League of Associations of Rheumatology (PANLAR) and the Assessment in SpondyloArthritis International Society/European Alliance of Associations for Rheumatology (ASAS/EULAR), clinical differences and diverse socioeconomic contexts justify the development of national guidelines.In recent years, great progress has been achieved both in the knowledge of the pathophysiology and in the pharmacological development for the treatment of AxSpA, which allows us to make more targeted and personalized therapeutic decisions. To date, no recommendation guidelines have been developed for the treatment of AxSpA in Argentina. There is evidence that shows that one of the most important factors for the adequate implementation of the guidelines in low-income countries is the effort to adapt them from the perspective of health care providers, which is why we consider their development locally to be of utmost importance. Therefore, the objective of the Study Group of the Argentine Society of Rheumatology (SAR) on AxSpA and Reactive Arthritis (GESARAxSpA-ARe) was to make recommendations for the therapeutic management of adult patients with AxSpA in our population.