Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists

被引：83

作者：

Sidiropoulos, P. I. ^{[1
]}

Hatemi, G. ^{[2
]}

Song, I. -H. ^{[3
]}

Avouac, J. ^{[4
]}

Collantes, E. ^{[5
]}

Hamuryudan, V. ^{[2
]}

Herold, M. ^{[6
]}

Kvien, T. K. ^{[7
]}

Mielants, H. ^{[8
]}

Mendoza, J. M. ^{[9
]}

Olivieri, I. ^{[10
]}

Ostergaard, M. ^{[11
]}

Schachna, L. ^{[12
]}

Sieper, J. ^{[3
]}

Boumpas, D. T. ^{[1
]}

Dougados, M.

机构：

[1] Univ Crete, Sch Med, Div Rheumatol Allergy & Clin Immunol, Dept Internal Med, Iraklion 71500, Greece

[2] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey

[3] Charite, Dept Med Rheumatol, D-13353 Berlin, Germany

[4] Paris Descartes Univ, Sch Med, Cochin Teaching Hosp, Dept Rheumatol, Paris, France

[5] Reina Sofia Univ Hosp Cordoba, Dept Rheumatol, Cordoba, Spain

[6] Innsbruck Med Univ, Div Gen Internal Med, Clin Dept Internal Med, Innsbruck, Austria

[7] Diakonhjemmet Hosp, Dept Rheumatol, N-0319 Oslo, Norway

[8] Ghent Univ Hosp, Dept Rheumatol, B-9000 Ghent, Belgium

[9] Hosp Puerta Hierro, Serv Reumatol, Madrid, Spain

[10] San Carlo Hosp Potenza, Dept Rheumatol, Potenza, Italy

[11] Univ Copenhagen Hosp, DK-2100 Copenhagen, Denmark

[12] Austin Spondylitis, Melbourne, Vic, Australia

来源：

RHEUMATOLOGY | 2008年 / 47卷 / 03期

关键词：

ankylosing spondylitis; systemic literature search; recommendations; non-steroidal anti-inflammatory drugs; COX-II inhibitors; monitoring; diagnosis; treatment;

D O I：

10.1093/rheumatology/kem348

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. Methods. Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations we re presented using brief statements by each national group, following which the final international recommendations were formulated. Results. A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. Conclusion. Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.

引用

页码：355 / 361

页数：7

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