Treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope

Pharmacological management has advanced considerably since the 2015 British Society for Rheumatology axial spondyloarthritis (axSpA) guideline to incorporate new classes of biologic DMARDs (bDMARDs, including biosimilars), targeted synthetic DMARDs (tsDMARDs) and treatment strategies such as drug tapering. The aim of this guideline is to provide an evidence-based update on pharmacological management of adults with axSpA (including AS and non-radiographic axSpA) using b/tsDMARDs. This guideline is aimed at health-care professionals in the UK who care directly for people with axSpA, including rheumatologists, rheumatology specialist nurses, allied health professionals, rheumatology specialty trainees and pharmacists; people living with axSpA; and other stakeholders, such as patient organizations and charities. Lay Summary What does this mean for patients? Axial spondyloarthritis, which includes ankylosing spondylitis, is an incurable condition that typically affects the spine. It can significantly reduce quality of life and ability to perform everyday activities. The British Society for Rheumatology develops guidelines to help health professionals to provide treatment according to the latest scientific research. Many new treatments have become available since the last version of the guideline. This paper sets out the plan to update the guideline for axial spondyloarthritis, which will focus on how and when to use high-cost drugs. The guideline working group will include a range of health professionals, people with axial spondyloarthritis and representation from the axial spondyloarthritis charity. This guideline update will be developed using the methods and processes outlined in British Society for Rheumatology (BSR) Creating Clinical Guidelines: Our Protocol [].