Pavelka K. and the Committee of the Czech Society for Rheumatology. Recommendations of the Czech Society for Rheumatology the Pharmacological Treatment of Axial Spondyloarthritis Part I. Treatment and pharmacotherapy strategies

Authors: K. Pavelka;  Společnosti České Revmatologické Výbor
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 29, 2021, No. 1, p. 5-19.
Category: Recomendation


The recommendations of the Czech Society for Rheumatology (ČRS) for the treatment of ankylosing spondylitis (AS) were published in 2012, and, therefore, the decision of the ČRS committee proceeded to the innovation of these criteria. It was based on the ASAS / EULAR recommendations for the treatment of axial spondyloarthritis, published in 2017, which are based on published records and the consensus of leading experts. Compared to the older criteria, there are several important innovations. The first and fundamental difference is the fact that these recommendations already apply to patients with a wider range of axial spondyloarthritis (SpA), i.e., radiographic and non-radiographic SpA and not just ankylosing spondylitis. There is also some innovation in views on the evaluation of disease activity so that the ASDAS score is now preferred. The intentions of this score also define a threshold for the initiation of biologic therapy (ASDAS ≥ 2.1) and more specifically defined treatment targets. Another new element is the introduction of newer drugs, i.e., IL-17 inhibitors. The current recommendations list IL-17 inhibitors as an alternative to first-line treatment with TNF inhibitors. These recommendations also include instructions on how to proceed in patients with extra-articular symptoms, i.e., acute anterior uveitis, idiopathic inflammatory bowel disease, and osteoporosis.


axial spondyloarthritis – biological treatment – disease activity – recommended procedures


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