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A survey of European and Canadian rheumatologists regarding the treatment of patients with ankylosing spondylitis and extra-articular manifestations

Filip Van den Bosch UGent (2010) CLINICAL RHEUMATOLOGY. 29(3). p.281-288
abstract
Ankylosing spondylitis (AS) is a disabling inflammatory disease accompanied by a variety of extra-articular manifestations in a significant number of patients. These manifestations, including Crohn's disease, ulcerative colitis, psoriasis, and uveitis, share a similar inflammatory mechanism with one another and with AS. Extra-articular manifestations are observed in a larger percentage of patients with AS and spondyloarthritides (SpAs) than the normal population; therefore, it is important to identify these and other inflammatory-mediated conditions and consider them when treating SpAs. How rheumatologists approach patients with both AS and extra-articular manifestations may lead to a better understanding of what treatment approaches could be taken to optimize patient outcomes. Rheumatologists (N = 453) from five European countries and Canada who treat AS were surveyed to determine treatment practices and management of both AS and its associated extra-articular manifestations. Most rheumatologists (93%) believe AS could be diagnosed earlier as the average time between symptom onset and diagnosis was approximately 4 years. In total, 60% routinely screen patients with AS for extra-articular manifestations, although this varied considerably across countries. The majority (97%) agrees that controlling inflammation is critical during treatment, and patients with extra-articular manifestations tend to have poorer prognoses than those patients with only axial AS. Treatment considerations varied depending on whether patients presented with only axial AS or had extra-articular manifestations, where use of biologics became more common. Rheumatologists agree that patients with both AS and extra-articular manifestations require a different treatment strategy than patients with AS alone. Results of this survey highlight areas where rheumatologists differ in their clinical management of patients with AS including tools used for disease assessment and the routine screening, or lack thereof, for other inflammatory diseases. This evidence may suggest aspects within clinical practice where modifications may be made in order to optimize patient outcomes.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
SPONDYLARTHROPATHY PATIENTS, CROHNS-DISEASE, QUALITY-OF-LIFE, SOCIETY CLASSIFICATION CRITERIA, RHEUMATOID-ARTHRITIS, PART II, SPONDYLOARTHRITIS, INFLIXIMAB, EFFICACY, SACROILIITIS
journal title
CLINICAL RHEUMATOLOGY
Clin. Rheumatol.
volume
29
issue
3
pages
281 - 288
Web of Science type
Article
Web of Science id
000274034600006
JCR category
RHEUMATOLOGY
JCR impact factor
1.687 (2010)
JCR rank
20/29 (2010)
JCR quartile
3 (2010)
ISSN
0770-3198
DOI
10.1007/s10067-009-1317-6
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1095422
handle
http://hdl.handle.net/1854/LU-1095422
date created
2011-01-07 09:33:37
date last changed
2016-12-19 15:46:20
@article{1095422,
  abstract     = {Ankylosing spondylitis (AS) is a disabling inflammatory disease accompanied by a variety of extra-articular manifestations in a significant number of patients. These manifestations, including Crohn's disease, ulcerative colitis, psoriasis, and uveitis, share a similar inflammatory mechanism with one another and with AS. Extra-articular manifestations are observed in a larger percentage of patients with AS and spondyloarthritides (SpAs) than the normal population; therefore, it is important to identify these and other inflammatory-mediated conditions and consider them when treating SpAs. How rheumatologists approach patients with both AS and extra-articular manifestations may lead to a better understanding of what treatment approaches could be taken to optimize patient outcomes. Rheumatologists (N = 453) from five European countries and Canada who treat AS were surveyed to determine treatment practices and management of both AS and its associated extra-articular manifestations. Most rheumatologists (93\%) believe AS could be diagnosed earlier as the average time between symptom onset and diagnosis was approximately 4 years. In total, 60\% routinely screen patients with AS for extra-articular manifestations, although this varied considerably across countries. The majority (97\%) agrees that controlling inflammation is critical during treatment, and patients with extra-articular manifestations tend to have poorer prognoses than those patients with only axial AS. Treatment considerations varied depending on whether patients presented with only axial AS or had extra-articular manifestations, where use of biologics became more common. Rheumatologists agree that patients with both AS and extra-articular manifestations require a different treatment strategy than patients with AS alone. Results of this survey highlight areas where rheumatologists differ in their clinical management of patients with AS including tools used for disease assessment and the routine screening, or lack thereof, for other inflammatory diseases. This evidence may suggest aspects within clinical practice where modifications may be made in order to optimize patient outcomes.},
  author       = {Van den Bosch, Filip},
  issn         = {0770-3198},
  journal      = {CLINICAL RHEUMATOLOGY},
  keyword      = {SPONDYLARTHROPATHY PATIENTS,CROHNS-DISEASE,QUALITY-OF-LIFE,SOCIETY CLASSIFICATION CRITERIA,RHEUMATOID-ARTHRITIS,PART II,SPONDYLOARTHRITIS,INFLIXIMAB,EFFICACY,SACROILIITIS},
  language     = {eng},
  number       = {3},
  pages        = {281--288},
  title        = {A survey of European and Canadian rheumatologists regarding the treatment of patients with ankylosing spondylitis and extra-articular manifestations},
  url          = {http://dx.doi.org/10.1007/s10067-009-1317-6},
  volume       = {29},
  year         = {2010},
}

Chicago
Van den Bosch, Filip. 2010. “A Survey of European and Canadian Rheumatologists Regarding the Treatment of Patients with Ankylosing Spondylitis and Extra-articular Manifestations.” Clinical Rheumatology 29 (3): 281–288.
APA
Van den Bosch, Filip. (2010). A survey of European and Canadian rheumatologists regarding the treatment of patients with ankylosing spondylitis and extra-articular manifestations. CLINICAL RHEUMATOLOGY, 29(3), 281–288.
Vancouver
1.
Van den Bosch F. A survey of European and Canadian rheumatologists regarding the treatment of patients with ankylosing spondylitis and extra-articular manifestations. CLINICAL RHEUMATOLOGY. 2010;29(3):281–8.
MLA
Van den Bosch, Filip. “A Survey of European and Canadian Rheumatologists Regarding the Treatment of Patients with Ankylosing Spondylitis and Extra-articular Manifestations.” CLINICAL RHEUMATOLOGY 29.3 (2010): 281–288. Print.