ankylosing%20spondylitis
ANKYLOSING SPONDYLITIS
Spondyloarthritis refers to a group of inflammatory diseases characterized by spinal & joint oligoarthritis, enthesitis, and sometimes mucocutaneous, ocular and/or cardiac manifestations.
Ankylosing spondylitis is a prototype of spondyloarthritis, particularly of the axial form.
Diagnosis of ankylosing spondylitis is definite if any of the radiological criterion (grade≥2 bilateral sacroiliitis or grade ≥3 unilateral sacroiliitis) is associated with at least one of the clinical criterion (low back pain & stiffness for >3 months that improves with exercise but not relieved by rest, limitation of motion of the lumbar spine in the sagittal and frontal planes, limitation of chest expansion relative to normal values correlated for age and gender.
  1. Braun J, van der Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2011 Jun;70(6):896-904. doi: 10.1136/ard.2011.151027. PMID: 21540199
  2. Braun J, Sieper J. Early diagnosis of spondyloarthritis. Nature Clin Prac Rheum. 2006 Oct;2(10):536-545. doi:10.1038/ncprheum0296. PMID: 17016479
  3. Akgul O, Ozgocmen S. Classification criteria for spondyloarthropathies. World J Orthop. 2011 Dec;2(12):107-115. http://www.wjgnet.com/2218-5836/pdf/v2/i12/107.pdf. Accessed 20 Sep 2013. PMID: 22474629
  4. Kain T, Zochling J, Taylor A, et al. Evidence-based recommendations for the diagnosis of ankylosing spondylitis: results from the Australian 3E initiative in rheumatology. Med J Aust. 2008 Feb;188(4):235-237. https://www.mja.com.au/system/files/issues/188_04_180208/kai10788_fm.pdf. PMID: 18279132
  5. Sieper J, Rudwaleit M, Baraliakos X, et al. The assessment of spondyloarthritis international society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009 Jun;68(Suppl 2):ii1-ii44. doi: 10.1136/ard.2008.104018. PMID: 19433414
  6. Harper BE, Reveille JD. Spondyloarthritis: clinical suspicion, diagnosis, and sports. Curr Sports Med Rep. 2009 Feb;8(1):29-34. doi: 10.1249/JSR.0b013e3181967ac6. PMID: 19142077
  7. Mansour M, Cheema GS, Naguwa SM, et al. Ankylosing spondylitis: a contemporary perspective on diagnosis and treatment. Semin Arthritis Rheum. 2007 Feb;36(4):210-223. PMID: 17011612
  8. National Institute for Health and Care Excellence. NICE recommends golimumab for ankylosing spondylitis. NICE. http://www.nice.org.uk/newsroom/pressreleases/GolimumabForAnkylosingSpondylitisFinalGuidance.jsp. Aug 2011
  9. National Institute for Health and Care Excellence. NICE guidance on biologic drugs for the treatment of ankylosing spondylitis. NICE. http://www.nice.org.uk/newsroom/news/NICERecommendsDrugForTheTreatmentOfAnkylosingSpondylitis.jsp. Aug 2011
  10. Keith MP. Overview of drug therapy for spondyloarthritis. Rheumatol Curr Res. 2013;3:119. http://omicsonline.org/overview-of-drug-therapy-for-spondyloarthritis-2161-1149.1000119.pdf. Accessed 28 Aug 2014.
  11. Smolen JS, Braun J, Dougados M, et al. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis. 2014 Jan;73(1):6-16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888616/pdf/annrheumdis-2013-203419.pdf. Accessed 27 May 2016. PMID: 23749611
  12. Braun J, Davis J, Dougados M, et al. First update of the international ASAS consensus statement for the use of anti-TNF agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2006 Mar;65(3):316-320. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798064/pdf/316.pdf. PMID: 16096329
  13. National Institute for Health and Clinical Excellence (NICE). Review of TA143; Adalimumab, etanercept and infliximab for ankylosing spondylitis. NICE. https://www.nice.org.uk/guidance/ta143/resources/guidance-adalimumab-etanercept-and-infliximab-for-ankylosing-spondylitis-pdf. May 2008.
  14. Mandl P, Navarro-Compán V, Terslev L, et al; European League Against Rheumatism (EULAR). EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015 Jul;74(7):1327-1339. http://ard.bmj.com/content/early/2015/04/02/annrheumdis-2014-206971.full.pdf+html. PMID: 25837448
  15. Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2016 Feb;68(2):282-298. doi: 10.1002/art.39298. PMID: 26401991
  16. Wendling D, Lukas C, Paccou J, et al; French Society for Rheumatology (SFR). Recommendations of the French Society for Rheumatology (SFR) on the everyday management of patients with spondyloarthritis. Joint Bone Spine. 2014 Jan;81(1):6-14. doi: 10.1016/j.jbspin.2013.12.002. PMID: 24412120
  17. van der Heijde D, Ramiro S, Landewe R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017 Jun;76(6):978-991. doi: 10.1136/annrheumdis-2016-210770. PMID: 28087505
  18. Yu DT. Assessment and treatment of ankylosing spondylitis in adults. UpToDate. www.uptodate.com. May 2018.
  19. Yu DT, van Tubergen A. Clinical manifestations of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults. UpToDate. www.uptodate.com. Oct 2018.
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