The profiling of axial spondyloarthritis patient candidate to a biologic therapy: Consensus from a Delphi-panel of Italian experts

GISEA Study Group

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish
Pages (from-to)1251-1258
Number of pages8
JournalAutoimmunity Reviews
Volume17
Issue number12
DOIs
Publication statusPublished - Dec 2018

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Biological Therapy
Uveitis
Biological Factors
Therapeutics

Keywords

  • Biological Factors/therapeutic use
  • Consensus
  • Disease Progression
  • Expert Testimony
  • Humans
  • Italy
  • Patient Selection
  • Spondylarthritis/drug therapy

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The profiling of axial spondyloarthritis patient candidate to a biologic therapy : Consensus from a Delphi-panel of Italian experts. / GISEA Study Group.

In: Autoimmunity Reviews, Vol. 17, No. 12, 12.2018, p. 1251-1258.

Research output: Contribution to journalReview article

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title = "The profiling of axial spondyloarthritis patient candidate to a biologic therapy: Consensus from a Delphi-panel of Italian experts",
abstract = "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.",
keywords = "Biological Factors/therapeutic use, Consensus, Disease Progression, Expert Testimony, Humans, Italy, Patient Selection, Spondylarthritis/drug therapy",
author = "{GISEA Study Group} and Favalli, {Ennio Giulio} and Andrea Becciolini and Roberto Caporali and Monica Todoerti and Florenzo Iannone and Liliana Dinoia and Marco Sebastiani and Amelia Spinella and Elisa Gremese and Francesco Cianci and Fabiola Atzeni and Francesca Bandinelli and Gianfranco Ferraccioli and Giovanni Lapadula",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = "12",
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language = "English",
volume = "17",
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journal = "Autoimmunity Reviews",
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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 -