Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial Spondyloarthritis

Hatice BODUR1, Fatma Gül YURDAKUL2, Şebnem ATAMAN3, Yeşim GARİP2, Kemal NAS4, Fikriye Figen AYHAN5,6, Özgür AKGÜL7, Ayşen AKINCI8, Zuhal ALTAY9, Murat BİRTANE10, Derya SOY BUĞDAYCI11, Erhan ÇAPKIN12, Remzi ÇEVİK13, Tuncay DURUÖZ14, Gülcan GÜRER15, Cahit KAÇAR16, Ayhan KAMANLI17, Ece KAPTANOĞLU18, Taciser KAYA19, Hilal KOCABAŞ20, Ömer KURU21, Meltem Alkan MELİKOĞLU22, Erhan ÖZDEMİREL23, Sumru ÖZEL24, Aylin REZVANİ25, İlhan SEZER26, İsmihan SUNAR3, Gürkan YILMAZ3

1Department of Physical Medicine and Rehabilitation, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
2Department of Physical Medicine and Rehabilitation, SBÜ Ankara Numune Training and Research Hospital, Ankara, Turkey
3Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara University School of Medicine, Ankara, Turkey
4Department of Physical Medicine and Rehabilitation, Sakarya University School of Medicine, Sakarya, Turkey
5Department of Physical Therapy and Rehabilitation, School of Health Sciences, Uşak University, Uşak, Turkey
6Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
7Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Celal Bayar University School of Medicine, Manisa, Turkey
8Department of Physical Medicine and Rehabilitation, Hacettepe University School of Medicine, Ankara, Turkey
9Department of Physical Medicine and Rehabilitation, İnönü University School of Medicine, Malatya, Turkey
10Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
11Department of Physical Medicine and Rehabilitation, SBÜ İstanbul Training and Research Hospital, İstanbul, Turkey
12Department of Physical Medicine and Rehabilitation, Karadeniz Teknik University School of Medicine, Trabzon, Turkey
13Department of Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakir, Turkey
14Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
15Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
16Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
17Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sakarya University School of Medicine, Sakarya, Turkey
18Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sivas Cumhuriyet University School of Medicine, Sivas, Turkey
19Department of Physical Medicine and Rehabilitation, SBÜ İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
20Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
21Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
22Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University School of Medicine, Erzurum, Turkey
23Department of Rheumatology, SBÜ Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
24Department of Physical Medicine and Rehabilitation, Hitit University School of Medicine, Çorum, Turkey
25Department of Physical Medicine and Rehabilitation, Bezmialem University School of Medicine, İstanbul, Turkey
26Department of Physical Medicine and Rehabilitation, SBÜ Antalya Training and Research Hospital, Antalya, Turkey

Keywords: Axial spondyloarthritis; comorbidities; exercises; nonpharmacological management; treatment

Abstract

Objectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloArthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice.
Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation.
Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength.
Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific
evidence. These recommendations will be updated regularly in accordance with current developments.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.