Recommendations of the French Society for Rheumatology (SFR) on the everyday management of patients with spondyloarthritis - 10/01/14

Doi : 10.1016/j.jbspin.2013.12.002

Daniel Wendling ^a,^⁎ , Cédric Lukas ^b,^{^{1
Contributed equally to this work.}}, Julien Paccou ^c,^d,^{^{1
Contributed equally to this work.}}, Pascal Claudepierre ^e,^f, Laurence Carton ^g, Bernard Combe ^h, Philippe Goupille ⁱ, Francis Guillemin ^j, Christophe Hudry ^k, Corinne Miceli-Richard ^l, Maxime Dougados ^m
^a Service de rhumatologie, université de Franche-Comté (EA 4266), CHRU de Besançon, boulevard Fleming, 25030 Besançon, France
^b Hôpital Lapeyronie, Montpellier, Institut Universitaire de Recherche Clinique (EA2415), 34000 Montpellier, France
^c Département de rhumatologie, CHU d’Amiens, 80000 Amiens, France
^d Inserm U1088, UFR Médecine/Pharmacie, Université de Picardie Jules-Verne, 80000 Amiens, France
^e Université Paris Est Créteil, Laboratoire d’Investigation Clinique (LIC) EA4393, 94010 Créteil, France
^f AP–HP, Hôpital Henri-Mondor, Service de Rhumatologie, 94000 Créteil, France
^g Association France Spondylarthrites, 19000 Tulle, France
^h Departement de Rhumatologie, CHU Lapeyronie,Université Montpellier 1, 34000 Montpellier, France
ⁱ CHRU de Tours, service de rhumatologie, UMR CNRS 7292, Université François-Rabelais de Tours, 37000 Tours, France
^j Inserm CIC-EC, CHU de Nancy, Service épidémiologie et évaluation cliniques, 54505 Nancy, France
^k Cabinet de Rhumatologie, 75008 Paris, France
^l Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, AP–HP, 94270 Le Kremlin-Bicêtre, France
^m Paris-Descartes University, Medicine Faculty, AP–HP, Cochin hospital, Rheumatology B Department, 75014 Paris, France

^⁎Corresponding author.

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Abstract

The management of spondyloarthritis is challenging and has changed with the development of new concepts and treatments.

Objective

To develop practice guidelines for the everyday management of patients with spondyloarthritis (including psoriatic arthritis), by updating previous national and international recommendations, based on a review of recently published data.

Methods

A task force and a multidisciplinary literature review group were established. The task force identified the issues that remained unresolved. Based on existing recommendations and recent publications, the task force developed practice guidelines, which were revised by the literature review group and graded according to AGREE.

Results

Practice guidelines for the management of spondyloarthritis are reported. After a review of the general diagnostic principles, 30 practice guidelines are given: 5 on general principles, 4 on the management strategy, 5 on non-pharmacological treatments, 7 on conventional pharmacological treatments, 6 on biotherapies, and 3 on surgical treatments and follow-up.

Conclusion

The updated practice guidelines reported here constitute a global framework that can guide physicians in the everyday management of spondyloarthritis.

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Keywords : Spondyloarthritis, Ankylosing spondylitis, Treatment, Rehabilitation, Therapeutic education, Physiotherapy, NSAIDs, TNFα antagonists