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dc.contributor.authorTruong, Steven L-
dc.contributor.authorMcEwan, Tim-
dc.contributor.authorBird, Paul-
dc.contributor.authorLim, Irwin-
dc.contributor.authorSaad, Nivene F-
dc.contributor.authorSchachna, Lionel-
dc.contributor.authorTaylor, Andrew L-
dc.contributor.authorRobinson, Philip C-
dc.identifier.citationRheumatology and Therapy 2022; 9(1):1-24en
dc.description.abstractThe 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. To update and expand the 2014 consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA). We 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. We 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. We provide 22 evidence-based consensus statements to provide practical guidance in the assessment and management of nr-axSpA.en
dc.subjectConsensus statementsen
dc.subjectNon-radiographic axial spondyloarthritisen
dc.subjectTNF inhibitoren
dc.titleAustralian Consensus Statements for the Assessment and Management of Non-radiographic Axial Spondyloarthritis.en
dc.typeJournal Articleen
dc.identifier.journaltitleRheumatology and Therapyen
dc.identifier.affiliationDepartment of Medicine, University of Melbourne, Parkville, VIC, Australiaen
dc.identifier.affiliationSchool of Medicine, University of Queensland, Brisbane, Australiaen
dc.identifier.affiliationMetro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australiaen
dc.identifier.affiliationBJC Health, Sydney, NSW, Australiaen
dc.identifier.affiliationSt George Hospital Clinical School, University of New South Wales, Sydney, Australiaen
dc.identifier.affiliationSchool of Clinical Medicine, University of Queensland, Herston, QLD, 4006, Australiaen
dc.identifier.affiliationDepartment of Rheumatology, Medical School, Fiona Stanley Hospital, University of Western Australia, Perth, Australiaen
dc.identifier.affiliationCoast Joint Care, Maroochydore, QLD, Australiaen
dc.identifier.affiliationSchool of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australiaen
dc.identifier.affiliationSchool of Clinical Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Herston, QLD, 4006, Australiaen
dc.identifier.affiliationMetro North, Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australiaen
dc.identifier.pubmedid34962620, Lionel
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
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