ReviewArthritis care & research2019
2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.
Review in Arthritis care & research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 177 papers, 10 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
177 citing papers in PubMed, 10 syntheses or guidelines pooled it, 678 citations in OpenAlex.
- Utilization of Rehabilitation Services Among People With Common Autoimmune Rheumatic Diseases: A Systematic Review.Arthritis care & research · 2026Pooled it
- The efficacy of complementary and alternative medicine non-pharmacological interventions in improving disease activity and inflammation in ankylosing spondylitis: a network meta-analysis.Frontiers in medicine · 2026Pooled it
- Guideline
- The effectiveness of different exercise mode interventions in improving disease activity in patients with ankylosing spondylitis: a network and dose-dependent meta-analysis.Frontiers in physiology · 2025Pooled it
- Efficacy of withdrawal or tapering of bDMARDs vs. standard regimen in axial spondyloarthritis patients: systematic review and meta-analysis informing the update of the Spanish Society of Rheumatology Guideline.Frontiers in medicine · 2025Pooled it
- Efficacy of acupuncture in the management of ankylosing spondylitis: a systematic review and meta-analysis with insights.Frontiers in neurology · 2025Pooled it
- Comparative efficacy and safety of bimekizumab in axial spondyloarthritis: a systematic literature review and network meta-analysis.Rheumatology (Oxford, England) · 2024Pooled it
- Pooled it
- The validity and reliability of quality of life questionnaires in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review and meta-analysis.Health and quality of life outcomes · 2022Pooled it
- Pooled it
- Vunakizumab for Radiographic Axial Spondyloarthritis: A Randomized Clinical Trial.JAMA network open · 2026Trial
- No major effect of age (< 40 vs. ≥ 40 years) on response to secukinumab in patients with axSpA: a post hoc analysis of six phase 3 trials.Arthritis research & therapy · 2026Trial
- Individualizing NSAID therapy in axial spondyloarthritis: N-of-1 trials with Bayesian analysis.Rheumatology (Oxford, England) · 2025Trial
- One-year effectiveness of long-term exercise therapy in people with axial spondyloarthritis and severe functional limitations.Rheumatology (Oxford, England) · 2025Trial
- Efficacy and safety of upadacitinib in patients with ankylosing spondylitis refractory to biologic therapy: 1-year results from the open-label extension of a phase III study.Arthritis research & therapy · 2023Trial
- CC-99677, a novel, oral, selective covalent MK2 inhibitor, sustainably reduces pro-inflammatory cytokine production.Arthritis research & therapy · 2022Trial
- Efficacy and Safety of Intravenous Golimumab in Ankylosing Spondylitis Patients With Early and Late Disease Through One Year of the GO-ALIVE Study.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2022Trial
- Trial
- Tofacitinib for the treatment of ankylosing spondylitis: a phase III, randomised, double-blind, placebo-controlled study.Annals of the rheumatic diseases · 2021Trial
- Dual neutralisation of interleukin-17A and interleukin-17F with bimekizumab in patients with active ankylosing spondylitis: results from a 48-week phase IIb, randomised, double-blind, placebo-controlled, dose-ranging study.Annals of the rheumatic diseases · 2020Trial
117 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 16 institutions in 2 countries.
Funding
Abstract
objectiveTo update evidence-based recommendations for the treatment of patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (SpA).
methodsWe conducted updated systematic literature reviews for 20 clinical questions on pharmacologic treatment addressed in the 2015 guidelines, and for 26 new questions on pharmacologic treatment, treat-to-target strategy, and use of imaging. New questions addressed the use of secukinumab, ixekizumab, tofacitinib, tumor necrosis factor inhibitor (TNFi) biosimilars, and biologic tapering/discontinuation, among others. We used the Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations and required at least 70% agreement among the voting panel.
resultsRecommendations for AS and nonradiographic axial SpA are similar. TNFi are recommended over secukinumab or ixekizumab as the first biologic to be used. Secukinumab or ixekizumab is recommended over the use of a second TNFi in patients with primary nonresponse to the first TNFi. TNFi, secukinumab, and ixekizumab are favored over tofacitinib. Co-administration of low-dose methotrexate with TNFi is not recommended, nor is a strict treat-to-target strategy or discontinuation or tapering of biologics in patients with stable disease. Sulfasalazine is recommended only for persistent peripheral arthritis when TNFi are contraindicated. For patients with unclear disease activity, spine or pelvis magnetic resonance imaging could aid assessment. Routine monitoring of radiographic changes with serial spine radiographs is not recommended.
conclusionThese recommendations provide updated guidance regarding use of new medications and imaging of the axial skeleton in the management of AS and nonradiographic axial SpA.
Indexed as
Identifiers
What OpenQuestion holds
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.