TY - JOUR
T1 - The profiling of axial spondyloarthritis patient candidate to a biologic therapy
T2 - Consensus from a Delphi-panel of Italian experts
AU - GISEA Study Group
AU - Favalli, Ennio Giulio
AU - Becciolini, Andrea
AU - Caporali, Roberto
AU - Todoerti, Monica
AU - Iannone, Florenzo
AU - Dinoia, Liliana
AU - Sebastiani, Marco
AU - Spinella, Amelia
AU - Gremese, Elisa
AU - Cianci, Francesco
AU - Atzeni, Fabiola
AU - Bandinelli, Francesca
AU - Ferraccioli, Gianfranco
AU - Lapadula, Giovanni
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2018/12
Y1 - 2018/12
N2 - OBJECTIVE: The project aimed to collect expert consensus statements for the profiling of patients with axial spondyloarthritis (axSpA) candidate to biologic agents (bDMARDs) treatment, in order to better define the drivers for the best treatment choice.METHODS: The 6 more interesting topics about axSpA patient profiling were identified by the project steering committee and a panel of axSpA Italian experts. A systematic literature review (SLR) was performed for each of the selected topics according to the PICO format. Two rounds of a modified Delphi process were conducted. In the 1st round, the steering committee evaluated the results of the SLR in order to formulate statements for each topic. In the 2nd round, the experts panel discussed, rephrased when needed, and voted the level of agreement (on a 5-point Likert-type scale) for each statement. Consensus was defined as ≥66% agreement.RESULTS: The topics selected for the analysis were the differential efficacy of available bDMARDs on enthesitis/dactylitis, uveitis, radiographic progression and cardiovascular involvement, and the clinical response in non radiographic-axSpA and in patients receiving a second-line bDMARD. The Delphi rounds formulated 19 statements, all reaching the defined level of consensus in a second round including 25 rheumatologists highly skilled in the management of axSpA.CONCLUSION: Identified consensus statements can help clinicians to apply to routine-care settings the results from clinical studies and international recommendations, providing a guide for individualization of treatment strategy in axSpA patients.
AB - OBJECTIVE: The project aimed to collect expert consensus statements for the profiling of patients with axial spondyloarthritis (axSpA) candidate to biologic agents (bDMARDs) treatment, in order to better define the drivers for the best treatment choice.METHODS: The 6 more interesting topics about axSpA patient profiling were identified by the project steering committee and a panel of axSpA Italian experts. A systematic literature review (SLR) was performed for each of the selected topics according to the PICO format. Two rounds of a modified Delphi process were conducted. In the 1st round, the steering committee evaluated the results of the SLR in order to formulate statements for each topic. In the 2nd round, the experts panel discussed, rephrased when needed, and voted the level of agreement (on a 5-point Likert-type scale) for each statement. Consensus was defined as ≥66% agreement.RESULTS: The topics selected for the analysis were the differential efficacy of available bDMARDs on enthesitis/dactylitis, uveitis, radiographic progression and cardiovascular involvement, and the clinical response in non radiographic-axSpA and in patients receiving a second-line bDMARD. The Delphi rounds formulated 19 statements, all reaching the defined level of consensus in a second round including 25 rheumatologists highly skilled in the management of axSpA.CONCLUSION: Identified consensus statements can help clinicians to apply to routine-care settings the results from clinical studies and international recommendations, providing a guide for individualization of treatment strategy in axSpA patients.
KW - Biological Factors/therapeutic use
KW - Consensus
KW - Disease Progression
KW - Expert Testimony
KW - Humans
KW - Italy
KW - Patient Selection
KW - Spondylarthritis/drug therapy
U2 - 10.1016/j.autrev.2018.07.002
DO - 10.1016/j.autrev.2018.07.002
M3 - Review article
C2 - 30339886
VL - 17
SP - 1251
EP - 1258
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
SN - 1568-9972
IS - 12
ER -