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Joint Bone Spine
Volume 74, n° 4
pages 330-337 (juillet 2007)
Doi : 10.1016/j.jbspin.2007.04.002
Received : 21 December 2006 ;  accepted : 26 April 2007
Clinical and laboratory follow-up for treating and monitoring patients with ankylosing spondylitis: Development of recommendations for clinical practice based on published evidence and expert opinion
 

Emmanuelle Dernis a, Frédéric Lavie b, Stéphan Pavy c, Daniel Wendling d, René-Marc Flipo e, Alain Saraux f, Alain Cantagrel g, Pascal Claudepierrre h, Philippe Goupille i, Xavier Le Loët j, Jean Francis Maillefert k, Xavier Mariette b, Thierry Schaeverbeke l, Jacques Tebib m, Bernard Combe n,
a Service de Rhumatologie, CH Le Mans, Le Mans, France 
b Service de Rhumatologie, CHU Bicêtre, AH-HP, Le Kremlin-Bicêtre, France 
c Service de Médecine Interne, CHU Pitié-Salpétrière, AP-HP, Paris, France 
d Service de Rhumatologie, CHU Jean Minjoz, Besançon, France 
e Service de Rhumatologie, CHU Roger Salengro, Lille, France 
f Service de Rhumatologie, CHU La Cavale Blanche, Brest, France 
g Service de Rhumatologie, CHU Toulouse, Toulouse, France 
h Service de Rhumatologie, CHU Henri Mondor, AP-HP, Créteil, France 
i Service de Rhumatologie, CHU Trousseau, Tours, France 
j Service de Rhumatologie, CHU Bois Guillaume, Rouen, France 
k Service de Rhumatologie, CHU Dijon, Dijon, France 
l Service de Rhumatologie, CHU Pellegrin, Bordeaux, France 
m Service de Rhumatologie, CHU Lyon, Lyon, France 
n Service de Rhumatologie, CHU Lapeyronie, CHU Lapeyronie, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France 

Corresponding author. Tel.: +33 4 67 33 87 10; fax: +33 4 67 33 73 11.
Abstract
Objective

To develop French recommendations about the clinical and laboratory follow-up of patients with axial ankylosing spondylitis (AS) seen in everyday practice.

Methods

The recommendations were developed based on evidence from the literature and on expert opinion. A Delphi consensus procedure was used by a scientific committee to select five focal points, about which evidence was obtained by searching Medline and the databases maintained by the French Society for Rheumatology, European League against Rheumatism, and American College of Rheumatology. The results of the literature review were used by a panel of experienced rheumatologists to draft and to validate the recommendations, using expert opinion if needed to supplement gaps in published knowledge. For each recommendation, the level of evidence and the level of agreement among the experts were specified.

Results

The three focal points selected using the Delphi procedure dealt with choosing the best clinical and laboratory parameters for monitoring patients with AS; whether follow-up benefits from the use of composite indices (e.g., the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], the BAS Functional Index [BASFI] and the BAS Metrology Index [BASMI]); and the clinical and laboratory parameters that predict functional or structural outcomes in patients with AS. The literature search retrieved 1510 relevant articles based on titles and abstracts, of which 322 were selected for in-depth review. Five recommendations about the clinical and laboratory follow-up of patients with AS were developed then validated by having all panel participants vote during a final meeting.

Conclusion

Recommendations about the clinical and laboratory follow-up of patients with AS were developed. They can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of patients with AS.

The full text of this article is available in PDF format.

Keywords : Ankylosing spondylitis, Evaluation, Clinical follow-up, Follow-up laboratory tests, Clinical practice, Patient




© 2007  Published by Elsevier Masson SAS.