Consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA)

Robinson, Philip C., Bird, Paul, Lim, Irwin, Saad, Nivene, Schachna, Lionel, Taylor, Andrew L., Whittle, Samuel L. and Brown, Matthew A. (2014) Consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA). International Journal of Rheumatic Diseases, 17 5: 548-556. doi:10.1111/1756-185X.12358

Author Robinson, Philip C.
Bird, Paul
Lim, Irwin
Saad, Nivene
Schachna, Lionel
Taylor, Andrew L.
Whittle, Samuel L.
Brown, Matthew A.
Title Consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA)
Journal name International Journal of Rheumatic Diseases   Check publisher's open access policy
ISSN 1756-185X
Publication date 2014-06
Year available 2014
Sub-type Article (original research)
DOI 10.1111/1756-185X.12358
Open Access Status
Volume 17
Issue 5
Start page 548
End page 556
Total pages 9
Place of publication Richmond VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2015
Language eng
Formatted abstract
Aim: Non-radiographic axial spondyloarthritis (nr-axSpA) is axial inflammatory arthritis where plain radiographic damage is not evident. An unknown proportion of these patients will progress to ankylosing spondylitis (AS). The increasing recognition of nr-axSpA has been greatly assisted by the widespread use of magnetic resonance imaging. The aim of this article was to construct a set of consensus statements based on a literature review to guide investigation and promote best management of nr-axSpA.

Methods: A literature review using Medline was conducted covering the major investigation modalities and treatment options available. A group of rheumatologists and a radiologist with expertise in investigation and management of SpA reviewed the literature and formulated a set of consensus statements. The Grade system encompassing the level of evidence and strength of recommendation was used. The opinion of a patient with nr-axSpA and a nurse experienced in the care of SpA patients was also sought and included.

Results: The literature review found few studies specifically addressing nr-axSpA, or if these patients were included, their results were often not separately reported. Fourteen consensus statements covering investigation and management of nr-axSpA were formulated. The level of agreement was high and ranged from 8.1 to 9.8. Treatment recommendations vary little with established AS, but this is primarily due to the lack of available evidence on the specific treatment of nr-axSpA.

Conclusion: The consensus statements aim to improve the diagnosis and management of nr-axSpA. We aim to raise awareness of this condition by the public and doctors and promote appropriate investigation and management.
Keyword Ankylosing spondylitis
Non-radiographic axial spondyloarthritis
Tumor necrosis factor-alpha inhibitors
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
UQ Diamantina Institute Publications
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