Improving the standard of care for patients with spondyloarthritis-related immune inflammatory conditions: results of a Delphi study and proposal for early detection.

BACKGROUND

Our objective was to provide consensus recommendations on the optimal management of the immune-mediated inflammatory diseases (IMIDs) seen in patients with spondyloarthritis (SpA) using a multidisciplinary approach, and to develop a simple tool to help earlier recognition and referral of coexisting IMIDs in patients who already have one type of IMID.

METHODS

A total of 28 experts in the multidisciplinary management of the SpA-associated IMIDs assessed two questionnaires: one with statements focused on the multidisciplinary management of IMIDs, and a second questionnaire focused on questions useful for early recognition and referral. Panelists assessed the statements with a 9-point ordinal scale (1 = strongly disagree, 9 = strongly agree) using a modified Delphi methodology.

RESULTS

Consensus was reached on 72 out of the 82 statements (87.8%). Panelists agreed that the multidisciplinary approach to IMIDs is not sufficiently developed. The creation of multidisciplinary IMID units might be necessary. These units might focus primarily on patients with two or more coexisting IMIDs, or on IMIDs that are especially complex from a diagnostic or therapeutic point of view. Specialists who attend to patients with IMIDs should perform a screening for other coexisting IMIDs. A simple tool to help earlier recognition and referral of coexisting IMIDs is proposed.

CONCLUSIONS

There is a need to improve care for patients with SpA-associated IMIDs. We provide expert recommendations to guide the adoption of a multidisciplinary approach for these cases, and a simple tool that may be useful for earlier recognition of coexisting IMIDs.

Informations de copyright

© The Author(s), 2020.

Déclaration de conflit d'intérêts

Conflict of interest statement: Pablo Coto has received honoraria, research grants, participated in advisory boards or acted as a speaker to Abbvie, Lilly, Novartis, Celgene, UCB, Janssen. Sabino Riestra has served as a speaker, consultant and advisory member for or has received research funding from MSD, Abbvie, Pfizer, Takeda, Janssen, Kern Pharma, Tillots Pharma, and Ferring. Rubén Queiro has received payments as panelist, lecturer, member of advisory boards and as researcher from Abbvie, MSD, Pfizer, Lilly, Novartis, Janssen, UCB, and Celgene. He has also received unrestricted research funds from Abbvie and Novartis. Paloma Rozas and Ana Señarís declare that they have no conflict of interest.