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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Due to the amount and variability in quality regarding the use of biologic therapy &#40;BT&#41; in patients with spondyloarthritis &#40;SpA&#41;&#44; except for psoriatic arthritis &#40;PsA&#41; patients&#44; the Spanish Society of Rheumatology has promoted the generation of recommendations based on the best evidence available&#46; These recommendations should be a reference for rheumatologists and those involved in the treatment of patients with spondyloarthritis &#40;SpA&#41;&#44; except for psoriatic arthritis &#40;PsA&#41;&#44; who are using&#44; or about to use BT&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recommendations were developed following a nominal group methodology and based on systematic reviews&#46; The level of evidence and grade of recommendation were classified according to the model proposed by the Center for Evidence Based Medicine at Oxford&#46; The level of agreement was established through Delphi technique&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We have produced recommendations on the use of BT currently available for SpA &#40;but not PsA&#41; in our country&#46; These recommendations include disease assessment&#44; treatment objectives&#44; therapeutic scheme and switching&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We present an update on the SER recommendations for the use of BT in patients with SpA&#44; except for PsA&#46;</p>"
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Original article
Consensus Statement of the Spanish Society of Rheumatology on the management of biologic therapies in Spondyloarthritis except for Psoriatic Arthritis
Documento SER de consenso sobre el uso de terapias biológicas en la espondilitis anquilosante y otras espondiloartritis, excepto la artritis psoriásica
Xavier Juanola Rouraa, Pedro Zarco Montejob, Jesús Sanz Sanzc, Santiago Muñoz Fernándezd, Juan Mulero Mendozac, Luis Francisco Linares Ferrandoe, Jordi Gratacós Masmitjaf, Rosario García de Vicuñag, Cristina Fernandez Carballidoh, Eduardo Collantes Estevezi, Enrique Batlle Gualdaj, Rafael Ariza Arizak, Estíbaliz Loza Santamaríal,
Corresponding author
estibaliz.loza@ser.es

Corresponding author.
a Servicio de Reumatología, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
b Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
c Servicio de Reumatología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
d Servicio de Reumatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
e Servicio de Reumatología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
f Servicio de Reumatología, Hospital Parc Taulí, Sabadell, Barcelona, Spain
g Servicio de Reumatología, Hospital Universitario de La Princesa, Madrid, Spain
h Servicio de Reumatología, Hospital General de Elda, Elda, Alicante, Spain
i Servicio de Reumatología, Hospital Universitario Reina Sofía, Córdoba, Spain
j Servicio de Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
k Servicio de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, Spain
l Unidad de Investigación, Sociedad Española de Reumatología, Madrid, Spain
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Due to the amount and variability in quality regarding the use of biologic therapy &#40;BT&#41; in patients with spondyloarthritis &#40;SpA&#41;&#44; except for psoriatic arthritis &#40;PsA&#41; patients&#44; the Spanish Society of Rheumatology has promoted the generation of recommendations based on the best evidence available&#46; These recommendations should be a reference for rheumatologists and those involved in the treatment of patients with spondyloarthritis &#40;SpA&#41;&#44; except for psoriatic arthritis &#40;PsA&#41;&#44; who are using&#44; or about to use BT&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recommendations were developed following a nominal group methodology and based on systematic reviews&#46; The level of evidence and grade of recommendation were classified according to the model proposed by the Center for Evidence Based Medicine at Oxford&#46; The level of agreement was established through Delphi technique&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We have produced recommendations on the use of BT currently available for SpA &#40;but not PsA&#41; in our country&#46; These recommendations include disease assessment&#44; treatment objectives&#44; therapeutic scheme and switching&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We present an update on the SER recommendations for the use of BT in patients with SpA&#44; except for PsA&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Dada la gran cantidad de informaci&#243;n sobre las terapias biol&#243;gicas &#40;TB&#41; en las espondiloartritis &#40;EspA&#41;&#44; excepto la artritis psori&#225;sica &#40;APs&#41;&#44; y la variabilidad en cuanto a su calidad&#44; desde la Sociedad Espa&#241;ola de Reumatolog&#237;a &#40;SER&#41; se ha impulsado la generaci&#243;n de recomendaciones basadas en la mejor evidencia posible&#46; Estas deben servir de referencia para reumat&#243;logos e implicados en el tratamiento de estos pacientes&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las recomendaciones se emitieron siguiendo la metodolog&#237;a de grupos nominales&#46; El nivel de evidencia y el grado de recomendaci&#243;n se clasificaron seg&#250;n el modelo del Center for Evidence Based Medicine de Oxford y el grado de acuerdo se extrajo por t&#233;cnica Delphi&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se realizan recomendaciones sobre el uso de las TB para el tratamiento de las EspA &#40;excepto la APs&#41;&#46; Incluyen la evaluaci&#243;n de la enfermedad&#44; objetivos del tratamiento&#44; esquema terap&#233;utico y cambios en &#233;ste&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se presentan las actualizaciones a las recomendaciones SER para el uso de TB en pacientes con EsA&#44; excepto la APs&#46;</p>"
      ]
    ]
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
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            0 => array:3 [
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              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of diagnostic criteria for ankylosing spondylitis&#46; A proposal for modification of the New York criteria"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
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                    ]
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            1 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On the difficulties of establishing a consensus on the definition of and diagnostic investigations for reactive arthritis&#46; Results and discussion of a questionnaire prepared for the 4th International Workshop on Reactive Arthritis&#44; Berlin&#44; Germany&#44; July 3-6&#44; 1999"
                      "autores" => array:1 [
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "fecha" => "2000"
                        "volumen" => "27"
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            2 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Classification criteria for psoriatic arthritis&#58; development of new criteria from a large international study"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                      "Revista" => array:6 [
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                      "autores" => array:1 [
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                    ]
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                      "titulo" => "Criteria of the classification of spondylarthropathies"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
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                    ]
                  ]
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                        "fecha" => "1990"
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                      "titulo" => "Mortality&#44; course of disease and prognosis of patients with ankylosing spondylitis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Exp Rheumatol&#46;"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "numero" => "6 Suppl 28"
                        "paginaInicial" => "S16"
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                      ]
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "The challenge of diagnosis and classification in early ankylosing spondylitis&#58; do we need new criteria&#63;"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.20990"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2005"
                        "volumen" => "52"
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                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New criteria for inflammatory back pain in patients with chronic back pain&#58; a real patient exercise by experts from the Assessment of SpondyloArthritis international Society &#40;ASAS&#41;"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/ard.2008.101501"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis&#46;"
                        "fecha" => "2009"
                        "volumen" => "68"
                        "paginaInicial" => "784"
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              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis &#40;part I&#41;&#58; classification of paper patients by expert opinion including uncertainty appraisal"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
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                    ]
                  ]
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                        "fecha" => "2009"
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                        "link" => array:1 [ …1]
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            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "New ASAS classification criteria for peripheral spondyloarthritis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Ann Rheum Dis&#46;"
                        "fecha" => "2009"
                      ]
                    ]
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                ]
              ]
            ]
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              "etiqueta" => "11&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The early disease stage in axial spondylarthritis&#58; results from the German Spondyloarthritis Inception Cohort"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.24483"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum&#46;"
                        "fecha" => "2009"
                        "volumen" => "60"
                        "paginaInicial" => "717"
                        "paginaFinal" => "727"
                        "link" => array:1 [ …1]
                      ]
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                ]
              ]
            ]
            11 => array:3 [
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              "etiqueta" => "12&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Ankylosing spondylitis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(07)60635-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet&#46;"
                        "fecha" => "2007"
                        "volumen" => "369"
                        "paginaInicial" => "1379"
                        "paginaFinal" => "1390"
                        "link" => array:1 [ …1]
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                    ]
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                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1002/1529-0131(199801)41:1<58::AID-ART8>3.0.CO;2-G"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum&#46;"
                        "fecha" => "1998"
                        "volumen" => "41"
                        "paginaInicial" => "58"
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                ]
              ]
            ]
            13 => array:3 [
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                      "titulo" => "The epidemiology of ankylosing spondylitis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
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                        "fecha" => "1993"
                        "volumen" => "22"
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            ]
            14 => array:3 [
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                ]
              ]
            ]
            15 => array:3 [
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              "etiqueta" => "16&#46;"
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                      ]
                    ]
                  ]
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                        "fecha" => "1994"
                        "volumen" => "21"
                        "paginaInicial" => "426"
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                ]
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                      "titulo" => "First signs and symptoms of spondyloarthritis &#8211;data from an inception cohort with a disease course of two years or less &#40;REGISPONSER-Early&#41;"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/ken506"
                      "Revista" => array:7 [
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                        "fecha" => "2009"
                        "volumen" => "48"
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                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum&#46;"
                        "fecha" => "1990"
                        "volumen" => "33"
                        "paginaInicial" => "1001"
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                  ]
                ]
              ]
            ]
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              "etiqueta" => "19&#46;"
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                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.3899/jrheum.090481"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol&#46;"
                        "fecha" => "2009"
                        "volumen" => "36"
                        "paginaInicial" => "2512"
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                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
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                  "contribucion" => array:1 [
                    0 => array:2 [
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                      "autores" => array:1 [
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                      ]
                    ]
                  ]
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                      "Revista" => array:6 [
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                        "fecha" => "2010"
                        "volumen" => "69"
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            20 => array:3 [
              "identificador" => "bib21"
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                        0 => array:2 [ …2]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Madrid&#58; SER"
                        "fecha" => "2010"
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            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondylarthropathies&#58; a Department of Veterans Affairs cooperative study"
                      "autores" => array:1 [
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                    ]
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                    0 => array:2 [
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                      "Revista" => array:6 [
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                        "fecha" => "1999"
                        "volumen" => "42"
                        "paginaInicial" => "2325"
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            22 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis&#58; a randomized clinical trial"
                      "autores" => array:1 [
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.21054"
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                        "tituloSerie" => "Arthritis Rheum&#46;"
                        "fecha" => "2005"
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              "etiqueta" => "24&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
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                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Santa Monica&#58; RAND"
                        "fecha" => "2001"
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                    ]
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                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:1 [
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                ]
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Article information
ISSN: 21735743
Original language: English
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