Evidence map›Paper›PMID 34962620›Full record

ArticleRheumatology and therapy2022

Australian Consensus Statements for the Assessment and Management of Non-radiographic Axial Spondyloarthritis.

Steven L Truong, Tim McEwan, Paul Bird, Irwin Lim, Nivene F Saad, Lionel Schachna, Andrew L Taylor, Philip C Robinson

Open access · goldAbstract read
In one paragraph

Article in Rheumatology and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.3field-weighted citation impact, top 37% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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

8 authors at 5 institutions in 1 country.

Steven L TruongSchool of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia. s.truong@griffith.edu.au.ORCID http://orcid.org/0000-0002-9093-3853
Tim McEwanSchool of Clinical Medicine, University of Queensland, Herston Rd, Herston, QLD, 4006, Australia.
Paul BirdSt George Hospital Clinical School, University of New South Wales, Sydney, Australia.
Irwin LimBJC Health, Sydney, NSW, Australia.
Nivene F SaadMetro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
Lionel SchachnaDepartment of Rheumatology, Austin Health, Heidelberg, VIC, Australia.
Andrew L TaylorDepartment of Rheumatology, Medical School, Fiona Stanley Hospital, University of Western Australia, Perth, Australia.
Philip C RobinsonMetro North, Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
The University of Queensland · AUGriffith University · AUThe University of Melbourne · AUThe University of Western Australia · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe understanding of non-radiographic axial spondyloarthritis (nr-axSpA) has accelerated over the last decade, producing a number of practice-changing developments. Diagnosis is challenging. No diagnostic criteria exist, no single finding is diagnostic, and other causes of back pain may act as confounders.

aimTo update and expand the 2014 consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA).

methodsWe created search questions based on our previous statements and four new topics then searched the MEDLINE and Cochrane databases. We assessed relevant publications by full-text review and rated their level of evidence using the GRADE system. We compiled a GRADE evidence summary then produced and voted on consensus statements.

resultsWe identified 5145 relevant publications, full-text reviewed 504, and included 176 in the evidence summary. We developed and voted on 22 consensus statements. All had high agreement. Diagnosis of nr-axSpA should be made by experienced clinicians, considering clinical features of spondyloarthritis, blood tests, and imaging. History and examination should also assess alternative causes of back pain and related conditions including non-specific back pain and fibromyalgia. Initial investigations should include CRP, HLA-B27, and AP pelvic radiography. Further imaging by T1 and STIR MRI of the sacroiliac joints is useful if radiography does not show definite changes. MRI provides moderate-to-high sensitivity and high specificity for nr-axSpA. Acute signs of sacroiliitis on MRI are not specific and have been observed in the absence of spondyloarthritis. Initial management should involve NSAIDs and a regular exercise program, while TNF and IL-17 inhibitors can be used for high disease activity unresponsive to these interventions. Goals of treatment include improving the frequent impairment of social and occupational function that occurs in nr-axSpA.

conclusionsWe provide 22 evidence-based consensus statements to provide practical guidance in the assessment and management of nr-axSpA.

Indexed as

Consensus statementsDiagnosisMRINon-radiographic axial spondyloarthritisTNF inhibitor

Identifiers

PMID34962620
PMCPMC8814294
OpenAlexW4200338856

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.