Summary Points Pertaining to the Management of axSpA
Early diagnosis and prompt treatment initiation are essential in the management of axSpA, using the ASAS classification criteria as a reference. Both under-diagnosis and over-diagnosis are prevalent. Management by a rheumatologist-led multidisciplinary team should include pharmacological therapy, physical activity and referral to a patient support organisation. The goal of therapy is to achieve r
Early diagnosis and prompt treatment initiation are essential in the management of axSpA, using the ASAS classification criteria as a reference. Both under-diagnosis and over-diagnosis are prevalent. Management by a rheumatologist-led multidisciplinary team should include pharmacological therapy, physical activity and referral to a patient support organisation.
The goal of therapy is to achieve remission (ASDAS <1.3), or at least low disease activity (ASDAS <2.1). Sequential therapy should be offered until this goal is achieved.
Screening and management of comorbidities including cardiovascular disease, infections, osteoporosis and depression should be undertaken.
axSpA = axial spondyloarthritis; ASAS = Assessment of SpondyloArthritis International Society; ASDAS = ankylosing spondylitis disease activity score.
Maharaj, A. B., et al. (2024). South African Rheumatism and Arthritis Association 2024 guidelines for the management of axial spondyloarthritis. South African Medical Journal, 114(10), e2668.