Evidence map›Paper›PMID 23749611›Full record

SynthesisAnnals of the rheumatic diseases2014

Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force.

Josef S Smolen, Jürgen Braun, Maxime Dougados, Paul Emery, Oliver Fitzgerald, Philip Helliwell, Arthur Kavanaugh, Tore K Kvien, Robert Landewé, Thomas Luger and 22 more

Registry-linked trialAbstract readConsensus StatementSystematic Review
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04399382 (A Clinical Study Using Damage-associated Molecular Pattern and Apparent Diffusion Coefficient to Evaluate the Efficacy of Biologics for Treating Spondyloarthritis), which is not on this map. Cited by 155 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
155citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04399382 unknown statusnot on this mapstarted 2022, after this paper: background citation

A Clinical Study Using Damage-associated Molecular Pattern and Apparent Diffusion Coefficient to Evaluate the Efficacy of Biologics for Treating Spondyloarthritis

TypeobservationalSponsorThe University of Hong Kong-Shenzhen HospitalRan2022 to 2022Enrolled40ConditionsSpondyloarthritis (SpA)ArmsBiologics
3 · Its place in the literature

Who cites it

155 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  5. Methotrexate for psoriatic arthritis.The Cochrane database of systematic reviews · 2019
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95 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Josef S SmolenDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, , Vienna, Austria.
Jürgen Braun
Maxime Dougados
Paul Emery
Oliver Fitzgerald
Philip Helliwell
Arthur Kavanaugh
Tore K Kvien
Robert Landewé
Thomas Luger
Philip Mease
Ignazio Olivieri
John Reveille
Christopher Ritchlin
Martin Rudwaleit
Monika Schoels
Joachim Sieper
Martinus de Wit
Xenofon Baraliakos
Neil Betteridge
Ruben Burgos-Vargas
Eduardo Collantes-Estevez
Atul Deodhar
Dirk Elewaut
Laure Gossec
Merryn Jongkees
Mara Maccarone
Kurt Redlich
Filip van den Bosch
James Cheng-Chung Wei
Kevin Winthrop
Désirée van der Heijde

Funding

Oregon Clinical and Translational Research InstituteUL1TR000128 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ELLISON, DAVID H · 2012 to 2015
$28.7M
NCATS NIH HHS UL1 TR000128Versus Arthritis 18475
6 · The paper itself

Abstract

backgroundTherapeutic targets have been defined for diseases like diabetes, hypertension or rheumatoid arthritis and adhering to them has improved outcomes. Such targets are just emerging for spondyloarthritis (SpA).

objectiveTo define the treatment target for SpA including ankylosing spondylitis and psoriatic arthritis (PsA) and develop recommendations for achieving the target, including a treat-to-target management strategy.

methodsBased on results of a systematic literature review and expert opinion, a task force of expert physicians and patients developed recommendations which were broadly discussed and voted upon in a Delphi-like process. Level of evidence, grade and strength of the recommendations were derived by respective means. The commonalities between axial SpA, peripheral SpA and PsA were discussed in detail.

resultsAlthough the literature review did not reveal trials comparing a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated the development of recommendations. The group agreed on 5 overarching principles and 11 recommendations; 9 of these recommendations related commonly to the whole spectrum of SpA and PsA, and only 2 were designed separately for axial SpA, peripheral SpA and PsA. The main treatment target, which should be based on a shared decision with the patient, was defined as remission, with the alternative target of low disease activity. Follow-up examinations at regular intervals that depend on the patient's status should safeguard the evolution of disease activity towards the targeted goal. Additional recommendations relate to extra-articular and extramusculoskeletal aspects and other important factors, such as comorbidity. While the level of evidence was generally quite low, the mean strength of recommendation was 9-10 (10: maximum agreement) for all recommendations. A research agenda was formulated.

conclusionsThe task force defined the treatment target as remission or, alternatively, low disease activity, being aware that the evidence base is not strong and needs to be expanded by future research. These recommendations can inform the various stakeholders about expert opinion that aims for reaching optimal outcomes of SpA.

Indexed as

Antirheumatic AgentsArthritis, PsoriaticHumansRheumatologySpondylarthritisSpondylitis, AnkylosingAntirheumatic Agentsankylosing spondylitispsoriatic arthritisspondyloarthritistherapyTreat-to-target

Identifiers

PMID23749611
PMCPMC3888616

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.