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. 2003 Sep;62(9):812–816. doi: 10.1136/ard.62.9.812

Initiation of biological agents in patients with ankylosing spondylitis: results of a Delphi study by the ASAS Group

T Pham 1, D van der Heijde 1, A Calin 1, M Khan 1, S van der Linden 1, N Bellamy 1, M Dougados 1
PMCID: PMC1754653  PMID: 12922951

Abstract

Background: There is ample evidence of important symptomatic efficacy of tumour necrosis factor α (TNFα) inhibition in ankylosing spondylitis (AS). Moreover, studies suggest that anti-TNF could be considered as the first disease controlling antirheumatic treatment (DC-ART) for AS.

Objective: To determine precisely which patients with AS are most likely to benefit from anti-TNFα treatment because of the cost and possible long term side effects of such treatment.

Methods: Assessment in Ankylosing Spondylitis (ASAS) members were asked to use a Delphi technique to name the characteristics of patients with AS for whom they would start DC-ART, in three different clinical presentations (isolated axial involvement, peripheral arthritis, enthesitis).

Results: Among the 62 invited ASAS members, more than 50% actively participated in the four phases of definition according to the Delphi technique. For each of the three clinical presentations, a combination of five to six domains was proposed, with an evaluation instrument and a cut off point defining a minimum level of activity for each domain.

Conclusion: This study provides a profile for a patient with AS for considering initiation of biological agents that reflects the opinion of the ASAS members, using a Delphi exercise. Further studies are required to assess their relevance and their consistency with clinical practice.

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Figure 1.

Figure 1

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Delphi technique: second turn results. Domains considered as relevant by the ASAS members in a patient with AS with (A) isolated axial involvement clinical presentation; (B) peripheral arthritis clinical presentation; and (C) enthesitis clinical presentation.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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