17 May 2023
Publication of the scope for the BSR guideline for the treatment of axial spondyloarthritis (axSpA) with biologic and targeted synthetic DMARDs marks the initiation of the rigorous and in-depth process to revise this key set of recommendations which will inform healthcare providers and ultimately improve outcomes for people living with axSpA.
Since the previous 2015 guideline, pharmacological management has advanced considerably to incorporate new classes of biologic DMARDs (bDMARD, including biosimilars), targeted synthetic DMARDs (tsDMARD), and treatment strategies such as drug tapering. The scope document provides an excellent insight into what the updated guideline will cover.
AxSpA is a chronic inflammatory disease that predominantly affects the spine and sacroiliac joints. It can also involve peripheral joints and entheses, and extra-musculoskeletal manifestations such as acute anterior uveitis, psoriasis and inflammatory bowel disease.
Lay member of the guideline working group (GWG), and CEO of the National Axial Spondyloarthritis Society (NASS), Dr Dale Webb, said, “AxSpA is a complex condition which affects different people in different ways, often with other related issues.
"Despite a widespread lack of awareness of the condition, axSpA is not rare and affects an estimated 1 in 200 of the adult population in the UK. It is very welcome that BSR are updating their guidance to reflect the latest high-quality evidence and NASS are pleased to be supporting the development to represent our members."
Co-chair of the GWG, Professor Karl Gaffney, consultant rheumatologist in Norwich, said, “The key aims of axSpA management are to control symptoms, restore function and quality of life, and to slow disease progression. Optimal management should be holistic – addressing musculoskeletal and extra-musculoskeletal manifestations as well as comorbidities – and include both pharmacological and non-pharmacological approaches.
"Multidisciplinary care is essential, so we have ensured the GWG developing this guideline is representative of this wider team, and also includes people living with axSpA."
The scope published today describes the key issues for the treatment of axSpA and includes draft questions, which will be used to develop more detailed review questions and methodology. The GWG will be working with the research team at Keele University School of Medicine to conduct the evidence review for the updated guideline, which is expected to publish in Spring 2024.
The full scope can be accessed now in the BSR open-access journal, Rheumatology Advances In Practice, here.
Access all the BSR guidelines via the guidelines homepage.
NICE accredits our clinical guideline process; this is valid until December 2023.