2025关于阿拉伯海湾国家轴性脊柱炎转诊、诊断、监测和管理的共识建议

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-09-09 DOI:10.1016/j.semarthrit.2025.152828

Khalid A. Alnaqbi , Ghaydaa Aldabie , Ahmad Al Enizi , Saadeya Abdulkarim , Eman Satti , Talal Al Lawati , Mohamed Bedaiwi , Denis Poddubnyy

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引用次数: 0

摘要

背景：目前在阿拉伯海湾地区管理轴性脊柱炎（axSpA）的标准化建议是有限的。目的：本研究旨在为阿拉伯海湾国家axSpA患者的转诊、诊断、监测和管理提供循证共识建议。方法由来自巴林、科威特、阿曼、卡塔尔、沙特阿拉伯和阿拉伯联合酋长国的七名风湿病专家组成的工作组，与一名顾问一起，根据PubMed、Medline和Cochrane数据库的系统文献综述（PROSPERO CRD42023403697），起草了关于axSpA患者护理的建议。共识要求同意度≥70%。来自该地区的患者研究伙伴和风湿病学家从外部验证了这些陈述。结果根据该地区的需要，制定了6项总体原则和21项建议。主要原则讨论了及时转诊给风湿病专家、HLA-B27的诊断效用、共同决策以及结合非药物和药物治疗的多学科管理。建议对风湿病学家和放射科医生进行影像学培训。骶髂关节MRI是诊断的首选，脊髓MRI或CT是sij的替代选择。应优先考虑具有成本效益的治疗方法，如生物仿制药和替代给药途径。治疗失败应促使重新评估诊断和评估合并症。建议定期监测心血管风险、妊娠计划、妊娠期间疾病活动监测，并使用患者报告的电子结果测量方法进行知情决策。区域和国家生物安全信息系统登记处可以促进证据生成和加强管理。结论：这些是针对阿拉伯海湾地区量身定制的第一个共识建议，整合了现有证据和区域专业知识，以优化axSpA患者的护理。

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2025 Consensus-based recommendations for the referral, diagnosis, monitoring, and management of axial spondyloarthritis in the Arabian Gulf countries

Background

Standardized recommendations for managing axial spondyloarthritis (axSpA) in the context of the Arabian Gulf region are currently limited.

Objective

We aimed to develop evidence-based consensus recommendations for the referral, diagnosis, monitoring, and management of axSpA patients in the Arabian Gulf countries.

Method

A task force of seven expert rheumatologists from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates, along with an advisor, drafted recommendations regarding axSpA patient care based on a systematic literature review (PROSPERO CRD42023403697) of PubMed, Medline, and Cochrane databases. Consensus required a level of agreement ≥70%. Patient research partners and rheumatologists from the region externally validated the statements.

Results

Six overarching principles and 21 recommendations, tailored to the needs of the region, were developed. Key principles discussed timely referral to rheumatologists, the diagnostic utility of HLA-B27, shared decision-making, and multidisciplinary management combining non-pharmacological and pharmacological treatment. Training rheumatologists and radiologists on imaging is recommended. MRI of sacroiliac joints is preferred for diagnosis, with spinal MRI or CT of SIJs as alternatives. Cost-effective treatments, such as biosimilars, and alternative routes of drug administration should be prioritized. Treatment failure should prompt reassessment of diagnosis and evaluation of comorbidities. Regularly monitoring cardiovascular risk, pregnancy planning, disease activity monitoring during pregnancy, and use of electronic patient-reported outcome measures for informed decisions are recommended. Regional and national axSpA registries can facilitate evidence generation and enhance management.

Conclusion

These are the first consensus recommendations tailored to the Arabian Gulf setting, integrating current evidence and regional expertise to optimize the care of axSpA patients.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.