Korean J Intern Med.
2023 Sep;38(5):620-640. 10.3904/kjim.2023.194.
Korean treatment recommendations for patients with axial spondyloarthritis
- Seo MR1
- Yeo J1
- Park JW2
- Lee YA3
- Lee JH4
- Kang EH4
- Ji SM5
- Kwon SR6
- Kim SK7
- Kim TJ8
- Kim TH9
- Kim HW10
- Park MC11
- Shin K12
- Lee SH13
- Lee EY2
- Cha HS14
- Shim SC15
- Yoon Y2
- Lee SH16
- Lim JH17
- Baek HJ
1 - on behalf of the Korean Society of Spondyloarthritis Research1
- Affiliations
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- 1Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- 2Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- 3Division of Rheumatology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
- 4Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 5National Health Insurance Service, Wonju, Korea
- 6Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine. Incheon, Korea
- 7Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
- 8Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
- 9Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- 10Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 11Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 12Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- 13Department of Rheumatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
- 14Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 15Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital. Daejeon, Korea
- 16Korea Ankylosing Spondylitis Society, Seoul, Korea
- 17Korea Ankylosing Spondylitis Corporation, Daejeon, Korea
- KMID: 2545688
- DOI: http://doi.org/10.3904/kjim.2023.194
Abstract
- We aimed to develop evidence-based recommendations for treating axial spondylarthritis (axSpA) in Korea. The development committee was constructed, key clinical questions were determined, and the evidence was searched through online databases including MEDLINE, Embase, Cochrane, KoreaMed, and Kmbase. Systematic literature reviews were conducted, quality of evidence was determined, and draft recommendations were formulated according to the Grading of Recommendations Assessment, Development, and Evaluations methodology. Recommendations that reached 80% consensus among a voting panel were finalized. Three principles and 21 recommendations were determined. Recommendations 1 and 2 pertain to treatment strategies, regular disease status assessment, and rheumatologist-steered multidisciplinary management. Recommendations 3 and 4 strongly recommend patient education, exercise, and smoking cessation. Recommendations 5–12 address pharmacological treatment of active disease using nonsteroidal anti-inflammatory drugs, glucocorticoids, sulfasalazine, biologics, and Janus kinase inhibitors. Recommendations 13–16 address treatment in stable disease. We suggest against spa and acupuncture as therapies (Recommendation 17). Recommendations 18 and 19 pertain to total hip arthroplasty and spinal surgery. Monitoring of comorbidities and drug toxicities are recommended (Recommendations 20 and 21). Recommendations for axSpA treatment in a Korean context were developed based on comprehensive clinical questions and evidence. These are intended to guide best practice in the treatment of axSpA.
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