Treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope

Sizheng Steven Zhao; Stephanie R Harrison; Antoni Chan; Nick Clarke; Charlotte Davis; Joe Eddison; William J Gregory; Gareth T Jones; Helena Marzo-Ortega; Daniel J Murphy; Virinderjit Sandhu; Raj Sengupta; Stefan Siebert; Ben Thompson; Dale Webb; Max Yates; Karl Gaffney

doi:10.1093/rap/rkad039

Treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope

Rheumatol Adv Pract. 2023 May 15;7(2):rkad039. doi: 10.1093/rap/rkad039. eCollection 2023.

Authors

Sizheng Steven Zhao¹, Stephanie R Harrison^{2

3}, Antoni Chan⁴, Nick Clarke⁵, Charlotte Davis⁶, Joe Eddison⁵, William J Gregory^{7

8}, Gareth T Jones⁹, Helena Marzo-Ortega^{2

3}, Daniel J Murphy¹⁰, Virinderjit Sandhu¹¹, Raj Sengupta¹², Stefan Siebert¹³, Ben Thompson¹⁴, Dale Webb¹⁵, Max Yates^{16

17}, Karl Gaffney¹⁷

Affiliations

¹ Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
² Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
³ NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
⁴ Department of Rheumatology, Royal Berkshire NHS Foundation Trust, Reading, UK.
⁵ Patient Expert.
⁶ Department of Rheumatology, Leeds Teaching Hospitals Trust, UK.
⁷ Rheumatology Department, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Greater Manchester, UK.
⁸ Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
⁹ Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK.
¹⁰ Department of Rheumatology, Honiton Surgery, Royal Devon & Exeter Hospital, Exeter, UK.
¹¹ Department of Rheumatology, St George's University Hospitals NHS Foundation Trust, London, UK.
¹² Royal National Hospital for Rheumatic Diseases, Royal United Hospitals, Bath, UK.
¹³ School of Infection and Immunity, University of Glasgow, Glasgow, UK.
¹⁴ Rheumatology Department, The Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK.
¹⁵ National Axial Spondyloarthritis Society (NASS), London, UK.
¹⁶ Centre for Epidemiology, Norwich Medical School, University of East Anglia, Norwich, UK.
¹⁷ Rheumatology Department, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK.

Abstract

Pharmacological management has advanced considerably since the 2015 British Society for Rheumatology axial spondyloarthritis (axSpA) guideline to incorporate new classes of biologic DMARDs (bDMARDs, including biosimilars), targeted synthetic DMARDs (tsDMARDs) and treatment strategies such as drug tapering. The aim of this guideline is to provide an evidence-based update on pharmacological management of adults with axSpA (including AS and non-radiographic axSpA) using b/tsDMARDs. This guideline is aimed at health-care professionals in the UK who care directly for people with axSpA, including rheumatologists, rheumatology specialist nurses, allied health professionals, rheumatology specialty trainees and pharmacists; people living with axSpA; and other stakeholders, such as patient organizations and charities.

Keywords: AS; Axial spondyloarthritis; IL17; JAK inhibitor; biologic; biosimilar; switching; tapering; treat-to-target.

Publication types

Review