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A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis
OBJECTIVE: The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA). METHODS: Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation...
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
Frontiers Media S.A.
2022
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| Materias: | |
| Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9510351/ https://www.ncbi.nlm.nih.gov/pubmed/36172360 http://dx.doi.org/10.3389/fimmu.2022.978504 |
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| author | Wu, Xinyu Liu, Dong Li, Yanfei Xie, Ya Tu, Liudan Zhang, Yanli Zhang, Xi Fang, Linkai Luo, Xiqing Lin, Zhiming Liao, Zetao Rong, Limin Ren, Jie Zhou, Yuqi Yang, Niansheng Xu, Jian Zhang, Hua Xu, Baijie Wu, Zhenbiao Zhan, Feng Li, Zhenbin Xiao, Weiguo Liu, Shengyun Zhou, Yi Ye, Shanhui Lv, Qing Zhang, Lijun Zhao, Dongbao He, Shanzhi Zhao, Like Wu, Lijun Lin, He Zhu, Yunxiao Guo, Donggeng Yang, Zehong Liu, Budian Yang, Kehu Gu, Jieruo |
| author_facet | Wu, Xinyu Liu, Dong Li, Yanfei Xie, Ya Tu, Liudan Zhang, Yanli Zhang, Xi Fang, Linkai Luo, Xiqing Lin, Zhiming Liao, Zetao Rong, Limin Ren, Jie Zhou, Yuqi Yang, Niansheng Xu, Jian Zhang, Hua Xu, Baijie Wu, Zhenbiao Zhan, Feng Li, Zhenbin Xiao, Weiguo Liu, Shengyun Zhou, Yi Ye, Shanhui Lv, Qing Zhang, Lijun Zhao, Dongbao He, Shanzhi Zhao, Like Wu, Lijun Lin, He Zhu, Yunxiao Guo, Donggeng Yang, Zehong Liu, Budian Yang, Kehu Gu, Jieruo |
| author_sort | Wu, Xinyu |
| collection | PubMed |
| description | OBJECTIVE: The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA). METHODS: Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation details were devised, followed by a systemic literature review. The Grading of Recommendations Assessment, Development, and Evaluation methodology was employed in the development of this guideline, with modifications to evaluate non-interventional approaches under comprehensive consideration of costs, accessibility, and evidence strength. A consensus from the voting panel was required for the inclusion of the final recommendations and the strength of each recommendation. RESULTS: Seventeen recommendations (including five strong recommendations) were included in this guideline. The voting panel expressed unequivocal support for the necessity of screening and assessment of enthesitis in patients with SpA. It was agreed unanimously that symptom evaluation and physical examination should serve as the initial steps to the recognition of enthesitis, whereas Maastricht Ankylosing Spondylitis Enthesitis Score is a reliable tool in both clinical trials and daily medical practice. Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition. Notwithstanding its high resolution, MRI is limited by the costs and relatively low accessibility, whereas radiographs had low sensitivity and therefore should be rendered obsolete in the assessment of enthesitis. PET/CT was strongly opposed in the detection of enthesitis. CONCLUSION: This guideline provides clinicians with information regarding the screening and assessment of enthesitis in patients with SpA. However, this guideline does not intend on dictating choices, and the ultimate decisions should be made in light of the actual circumstances of the facilities. |
| format | Online Article Text |
| id | pubmed-9510351 |
| institution | National Center for Biotechnology Information |
| language | English |
| publishDate | 2022 |
| publisher | Frontiers Media S.A. |
| record_format | MEDLINE/PubMed |
| spelling | pubmed-95103512022-09-27 A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis Wu, Xinyu Liu, Dong Li, Yanfei Xie, Ya Tu, Liudan Zhang, Yanli Zhang, Xi Fang, Linkai Luo, Xiqing Lin, Zhiming Liao, Zetao Rong, Limin Ren, Jie Zhou, Yuqi Yang, Niansheng Xu, Jian Zhang, Hua Xu, Baijie Wu, Zhenbiao Zhan, Feng Li, Zhenbin Xiao, Weiguo Liu, Shengyun Zhou, Yi Ye, Shanhui Lv, Qing Zhang, Lijun Zhao, Dongbao He, Shanzhi Zhao, Like Wu, Lijun Lin, He Zhu, Yunxiao Guo, Donggeng Yang, Zehong Liu, Budian Yang, Kehu Gu, Jieruo Front Immunol Immunology OBJECTIVE: The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA). METHODS: Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation details were devised, followed by a systemic literature review. The Grading of Recommendations Assessment, Development, and Evaluation methodology was employed in the development of this guideline, with modifications to evaluate non-interventional approaches under comprehensive consideration of costs, accessibility, and evidence strength. A consensus from the voting panel was required for the inclusion of the final recommendations and the strength of each recommendation. RESULTS: Seventeen recommendations (including five strong recommendations) were included in this guideline. The voting panel expressed unequivocal support for the necessity of screening and assessment of enthesitis in patients with SpA. It was agreed unanimously that symptom evaluation and physical examination should serve as the initial steps to the recognition of enthesitis, whereas Maastricht Ankylosing Spondylitis Enthesitis Score is a reliable tool in both clinical trials and daily medical practice. Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition. Notwithstanding its high resolution, MRI is limited by the costs and relatively low accessibility, whereas radiographs had low sensitivity and therefore should be rendered obsolete in the assessment of enthesitis. PET/CT was strongly opposed in the detection of enthesitis. CONCLUSION: This guideline provides clinicians with information regarding the screening and assessment of enthesitis in patients with SpA. However, this guideline does not intend on dictating choices, and the ultimate decisions should be made in light of the actual circumstances of the facilities. Frontiers Media S.A. 2022-09-12 /pmc/articles/PMC9510351/ /pubmed/36172360 http://dx.doi.org/10.3389/fimmu.2022.978504 Text en Copyright © 2022 Wu, Liu, Li, Xie, Tu, Zhang, Zhang, Fang, Luo, Lin, Liao, Rong, Ren, Zhou, Yang, Xu, Zhang, Xu, Wu, Zhan, Li, Xiao, Liu, Zhou, Ye, Lv, Zhang, Zhao, He, Zhao, Wu, Lin, Zhu, Guo, Yang, Liu, Yang and Gu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| spellingShingle | Immunology Wu, Xinyu Liu, Dong Li, Yanfei Xie, Ya Tu, Liudan Zhang, Yanli Zhang, Xi Fang, Linkai Luo, Xiqing Lin, Zhiming Liao, Zetao Rong, Limin Ren, Jie Zhou, Yuqi Yang, Niansheng Xu, Jian Zhang, Hua Xu, Baijie Wu, Zhenbiao Zhan, Feng Li, Zhenbin Xiao, Weiguo Liu, Shengyun Zhou, Yi Ye, Shanhui Lv, Qing Zhang, Lijun Zhao, Dongbao He, Shanzhi Zhao, Like Wu, Lijun Lin, He Zhu, Yunxiao Guo, Donggeng Yang, Zehong Liu, Budian Yang, Kehu Gu, Jieruo A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title | A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title_full | A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title_fullStr | A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title_full_unstemmed | A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title_short | A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| title_sort | clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis |
| topic | Immunology |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9510351/ https://www.ncbi.nlm.nih.gov/pubmed/36172360 http://dx.doi.org/10.3389/fimmu.2022.978504 |
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