Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

F. Rizzello, I. Olivieri, A. Armuzzi, F. Ayala, V. Bettoli, L. Bianchi, L. Cimino, A. Costanzo, A. Cristaudo, S. D’Angelo, M. Daperno, A.C. Fostini, M. Galeazzi, M. Gilio, P. Gionchetti, P. Gisondi, E. Lubrano, A. Marchesoni, A. Offidani, A. OrlandoD. Pugliese, C. Salvarani, R. Scarpa, M. Vecchi, G. Girolomoni

Research output: Contribution to journalArticle

Abstract

Introduction: Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis and uveitis. Methods: A Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements. Results: Consensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important. Conclusion: The present Delphi consensus identified a set of overarching principles that may be useful for implementation of a multidisciplinary approach for the management of SpA-related IMIDs. Funding: Aristea and Hippocrates. © 2018 The Author(s)
Original languageEnglish
Pages (from-to)545-562
Number of pages18
JournalAdvances in Therapy
Volume35
Issue number4
DOIs
Publication statusPublished - 2018

Fingerprint

Consensus
Psoriatic Arthritis
Uveitis
Politics
Patient Compliance
Patient Satisfaction
Ulcerative Colitis
Psoriasis
Crohn Disease
General Practitioners
Autoimmune Diseases
Early Diagnosis
Decision Making
Chronic Disease
Referral and Consultation
Nurses
Quality of Life
Psychology
Therapeutics
Ophthalmologists

Keywords

  • Crohn’s disease
  • Immune-mediated inflammatory disease
  • Multidisciplinary
  • Psoriasis
  • Psoriatic arthritis
  • Spondyloarthritis
  • Ulcerative colitis
  • Uveitis

Cite this

Rizzello, F., Olivieri, I., Armuzzi, A., Ayala, F., Bettoli, V., Bianchi, L., ... Girolomoni, G. (2018). Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease. Advances in Therapy, 35(4), 545-562. https://doi.org/10.1007/s12325-018-0672-6

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease. / Rizzello, F.; Olivieri, I.; Armuzzi, A.; Ayala, F.; Bettoli, V.; Bianchi, L.; Cimino, L.; Costanzo, A.; Cristaudo, A.; D’Angelo, S.; Daperno, M.; Fostini, A.C.; Galeazzi, M.; Gilio, M.; Gionchetti, P.; Gisondi, P.; Lubrano, E.; Marchesoni, A.; Offidani, A.; Orlando, A.; Pugliese, D.; Salvarani, C.; Scarpa, R.; Vecchi, M.; Girolomoni, G.

In: Advances in Therapy, Vol. 35, No. 4, 2018, p. 545-562.

Research output: Contribution to journalArticle

Rizzello, F, Olivieri, I, Armuzzi, A, Ayala, F, Bettoli, V, Bianchi, L, Cimino, L, Costanzo, A, Cristaudo, A, D’Angelo, S, Daperno, M, Fostini, AC, Galeazzi, M, Gilio, M, Gionchetti, P, Gisondi, P, Lubrano, E, Marchesoni, A, Offidani, A, Orlando, A, Pugliese, D, Salvarani, C, Scarpa, R, Vecchi, M & Girolomoni, G 2018, 'Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease', Advances in Therapy, vol. 35, no. 4, pp. 545-562. https://doi.org/10.1007/s12325-018-0672-6
Rizzello, F. ; Olivieri, I. ; Armuzzi, A. ; Ayala, F. ; Bettoli, V. ; Bianchi, L. ; Cimino, L. ; Costanzo, A. ; Cristaudo, A. ; D’Angelo, S. ; Daperno, M. ; Fostini, A.C. ; Galeazzi, M. ; Gilio, M. ; Gionchetti, P. ; Gisondi, P. ; Lubrano, E. ; Marchesoni, A. ; Offidani, A. ; Orlando, A. ; Pugliese, D. ; Salvarani, C. ; Scarpa, R. ; Vecchi, M. ; Girolomoni, G. / Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease. In: Advances in Therapy. 2018 ; Vol. 35, No. 4. pp. 545-562.
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T1 - Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

AU - Rizzello, F.

AU - Olivieri, I.

AU - Armuzzi, A.

AU - Ayala, F.

AU - Bettoli, V.

AU - Bianchi, L.

AU - Cimino, L.

AU - Costanzo, A.

AU - Cristaudo, A.

AU - D’Angelo, S.

AU - Daperno, M.

AU - Fostini, A.C.

AU - Galeazzi, M.

AU - Gilio, M.

AU - Gionchetti, P.

AU - Gisondi, P.

AU - Lubrano, E.

AU - Marchesoni, A.

AU - Offidani, A.

AU - Orlando, A.

AU - Pugliese, D.

AU - Salvarani, C.

AU - Scarpa, R.

AU - Vecchi, M.

AU - Girolomoni, G.

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PY - 2018

Y1 - 2018

N2 - Introduction: Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis and uveitis. Methods: A Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements. Results: Consensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important. Conclusion: The present Delphi consensus identified a set of overarching principles that may be useful for implementation of a multidisciplinary approach for the management of SpA-related IMIDs. Funding: Aristea and Hippocrates. © 2018 The Author(s)

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KW - Crohn’s disease

KW - Immune-mediated inflammatory disease

KW - Multidisciplinary

KW - Psoriasis

KW - Psoriatic arthritis

KW - Spondyloarthritis

KW - Ulcerative colitis

KW - Uveitis

U2 - 10.1007/s12325-018-0672-6

DO - 10.1007/s12325-018-0672-6

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