1
|
Fernández-Ávila DG, Bautista-Molano W, Brance ML, Ávila Pedretti MG, Burgos Vargas R, Díaz Coto JF, Gutiérrez LA, Gutiérrez M, Giraldo Ho E, Ibáñez Vodnizza SE, Jáuregui E, Ocampo V, Palominos PE, Palleiro Rivero DR, Andrés Quiceno G, Sommerfleck FA, Vega Espinoza LE, Vega Hinojosa O, Vera Barrezueta C, Corbacho I, Cosentino VL, Goecke Sariego A, Resende GG, Saldarriaga-Rivera LM, Pacheco Tena CF, Citera G, Lozada C, Ranza R, Sampaio-Barros PD, Schneeberger E, Soriano ER. Pan American League of Associations for Rheumatology Recommendations for the Treatment of Psoriatic Arthritis. J Rheumatol 2024:jrheum.2023-1172. [PMID: 38561190 DOI: 10.3899/jrheum.2023-1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Psoriatic arthritis (PsA) is chronic disease that compromises multiple domains and might be associated with progressive joint damage, increased mortality, functional limitation, and considerably impaired quality of life. Our objective was to generate evidence-based recommendations on the management of PsA in Pan American League of Associations for Rheumatology (PANLAR) countries. METHODS We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to adapt the 2019 recommendations of the European Alliance of Associations for Rheumatology. A working group consisting of rheumatologists from various countries in Latin America identified relevant topics for the treatment of PsA in the region. The methodology team updated the evidence and synthesized the information used to generate the final recommendations. These were then discussed and defined by a panel of 31 rheumatologists from 15 countries. RESULTS Theses guidelines report 15 recommendations addressing therapeutic targets, use of antiinflammatory agents and corticosteroids, treatment with disease-modifying antirheumatic drugs (conventional synthetic, biologic, and targeted synthetic), therapeutic failure, optimization of biologic therapy, nonpharmacological interventions, assessment tools, and follow-up of patients with PsA. CONCLUSION Here we present a set of recommendations to guide decision making in the treatment of PsA in Latin America, based on the best evidence available, considering resources, medical expertise, and the patient's values and preferences. The successful implementation of these recommendations should be based on clinical practice conditions, healthcare settings in each country, and a tailored evaluation of patients.
Collapse
Affiliation(s)
- Daniel G Fernández-Ávila
- D.G. Fernández-Ávila, MD, PhD, MSc, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia, and PANLAR Research Unit
| | - Wilson Bautista-Molano
- W. Bautista-Molano, MD, PhD, Hospital Universitario Fundación Santafé de Bogotá, Faculty of Medicine, Universidad El Bosque, Universidad Militar Nueva Granada, Bogota, and PANLAR Axial Spondyloarthritis and Psoriatic Arthritis Study Group, Colombia
| | - María Lorena Brance
- M.L. Brance, MD, PhD, Bone Metabolism, National Scientific and Technical Research Council (CONICET), and Bone Biology Laboratory, School of Medicine, and Rheumatology and Bone Diseases, and, Rosario, Argentina, and PANLAR Research Unit
| | - María Gabriela Ávila Pedretti
- M.G. Ávila Pedretti, MD, MSc, PhD, Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Departamento de Reumatología, San Lorenzo, and Registry of Adverse Events in Patients With Biological Therapy (BIOBADAGUAY) Group, Paraguay
| | | | - José Francisco Díaz Coto
- J.F. Díaz Coto, MD, Hospital Mexico, Centro de Contacto de Servicios de Salud (CCSS), San Jose, Costa Rica
| | - Luis Arturo Gutiérrez
- L.A. Gutiérrez, MD, UMIR Internal Medicine and Rheumatology Unit, Caracas, Venezuela
| | - Marwin Gutiérrez
- M. Gutiérrez, MD, National Institute of Rehabilitation, Mexico City, Mexico
| | - Enrique Giraldo Ho
- E. Giraldo Ho, MD, Clinic All, Pacífica Salud-Hospital Punta Pacífica, Panama City, Panama
| | - Sebastián Eduardo Ibáñez Vodnizza
- S.E. Ibáñez Vodnizza, MD, Clínica Alemana de Santiago, Hospital Padre Hurtado, Santiago, and Chilean SpA Patient Foundation (Espondilitis Chile), Chile
| | - Edwin Jáuregui
- E. Jáuregui, MD, MSc, Clinical Epidemiology, Member of the Asoreuma Spondyloarthritis Study Group, Socio de Riesgo de Fractura SA, CAYRE, Bogota, Colombia
| | - Vanessa Ocampo
- V. Ocampo, MD, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Daniel Ruben Palleiro Rivero
- D.R. Palleiro Rivero, MD, Cathedra of Rheumatology, University of Republic, Uruguayan Society of Rheumatology, Montevideo, Uruguay
| | - Guillermo Andrés Quiceno
- G. Andrés Quiceno, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fernando Andrés Sommerfleck
- F.A. Sommerfleck, MD, Sanatorio Dr. Julio Mendez, Buenos Aires, and PANLAR Axial Spondyloarthritis and Psoriatic Arthritis Study Group, Argentina
| | - Luis Enrique Vega Espinoza
- L.E. Vega Espinoza, MD, Hospital Central Fuerza Aérea, Faculty of Medicine, Universidad de Piura, Lima, Peru
| | - Oscar Vega Hinojosa
- O. Vega Hinojosa, MD, Centro Médico Reumacenter y Hospital III Red Asistencial Essalud, Juliaca, Peru
| | | | - Inés Corbacho
- I. Corbacho, MD, Cathedra of Rheumatology, University of the Republic, Uruguayan Society of Rheumatology, Montevideo, Uruguay
| | - Vanesa Laura Cosentino
- V.L. Cosentino, MD, Hospital Dr. J.M. Ramos Mejia, Buenos Aires, and Argentine Society of Rheumatology, Argentina
| | | | | | - Lina María Saldarriaga-Rivera
- L.M. Saldarriaga-Rivera, MD, Faculty of Medicine, Universidad Tecnológica de Pereira, Hospital Universitario San Jorge de Pereira, Risaralda, Colombia
| | - Cesar Francisco Pacheco Tena
- C.F. Pacheco Tena, MD, Faculty of Medicine, Universidad Autónoma de Chihuahua e Investigación y Biomedicina de Chihuahua SC, Chihuahua, Mexico
| | - Gustavo Citera
- G. Citera, MD, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Carlos Lozada
- C. Lozada, MD, Division of Rheumatology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Roberto Ranza
- R. Ranza, MD, Division of Rheumatology, Universidade Federal de Uberlàndia, Minas Gerais, Brazil
| | - Percival D Sampaio-Barros
- P.D. Sampaio-Barros, MD, PhD, Rheumatology Division, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Emilce Schneeberger
- E. Schneeberger, MD, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Enrique R Soriano
- E.R. Soriano, MD, MSc, Rheumatology Unit, Internal Medicine Services and University Institute, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
2
|
Bautista-Molano W, Fernández-Ávila DG, Brance ML, Ávila Pedretti MG, Burgos-Vargas R, Corbacho I, Cosentino VL, Díaz Coto JF, Giraldo Ho E, Gomes Resende G, Gutiérrez LA, Gutiérrez M, Ibáñez Vodnizza SE, Jáuregui E, Ocampo V, Palleiro Rivero DR, Palominos PE, Pacheco Tena C, Quiceno GA, Saldarriaga-Rivera LM, Sommerfleck FA, Goecke Sariego A, Vera Barrezueta C, Vega Espinoza LE, Vega Hinojosa O, Citera G, Lozada C, Sampaio-Barros PD, Schneeberger E, Soriano ER. Pan American League of Associations for Rheumatology recommendations for the management of axial spondyloarthritis. Nat Rev Rheumatol 2023; 19:724-737. [PMID: 37803079 DOI: 10.1038/s41584-023-01034-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/08/2023]
Abstract
Axial spondyloarthritis (axSpA) comprises a spectrum of chronic inflammatory manifestations affecting the axial skeleton and represents a challenge for diagnosis and treatment. Our objective was to generate a set of evidence-based recommendations for the management of axSpA for physicians, health professionals, rheumatologists and policy decision makers in Pan American League of Associations for Rheumatology (PANLAR) countries. Grading of Recommendations, Assessment, Development and Evaluation-ADOLOPMENT methodology was used to adapt existing recommendations after performing an independent systematic search and synthesis of the literature to update the evidence. A working group consisting of rheumatologists, epidemiologists and patient representatives from countries within the Americas prioritized 13 topics relevant to the context of these countries for the management of axSpA. This Evidence-Based Guideline article reports 13 recommendations addressing therapeutic targets, the use of NSAIDs and glucocorticoids, treatment with DMARDs (including conventional synthetic, biologic and targeted synthetic DMARDs), therapeutic failure, optimization of the use of biologic DMARDs, the use of drugs for extra-musculoskeletal manifestations of axSpA, non-pharmacological interventions and the follow-up of patients with axSpA.
Collapse
Affiliation(s)
- Wilson Bautista-Molano
- Hospital Universitario Fundación Santafé de Bogotá, Faculty of Medicine, Universidad El Bosque, Universidad Militar Nueva Granada, Bogotá, Colombia
| | | | - María Lorena Brance
- Bone Biology Laboratory, School of Medicine, Rosario National University, Rosario, Argentina
| | | | | | - Inés Corbacho
- Cátedra de Reumatologia, Universidad de la República UDELAR, Montevideo, Uruguay
| | | | | | | | | | | | - Marwin Gutiérrez
- Center of Excellence of Rheumatic and Musculoskeletal Diseases, C.E.R.M, Mexico City, Mexico
| | | | - Edwin Jáuregui
- Gestor de Reumatología de o en Riesgo de fractura S.A, Bogotá, Colombia
| | - Vanessa Ocampo
- Rheumatology, University of Toronto, Toronto, ON, Canada
| | | | | | - Cesar Pacheco Tena
- Facultad de Medicina, Universidad Autónoma de Chihuahua e Investigación y Biomedicina de Chihuahua SC, Chihuahua, Mexico
| | - Guillermo Andrés Quiceno
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lina María Saldarriaga-Rivera
- Faculty of Medicine, Universidad Tecnológica de Pereira, Hospital Universitario San Jorge de Pereira, Pereira, Risaralda, Colombia
| | | | | | | | | | - Oscar Vega Hinojosa
- Centro Médico Reumacenter y Hospital III Red Asistencial Essalud, Juliaca, Perú
| | - Gustavo Citera
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Carlos Lozada
- Division of Rheumatology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - Enrique R Soriano
- Rheumatology Unit, Internal Medicine Services and University Institute, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| |
Collapse
|