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Expert recommendations on early diagnosis and referral of axial spondyloarthritis in the Kingdom of Saudi Arabia

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Abstract

Axial spondyloarthritis is a chronic inflammatory disorder that primarily involves the axial skeleton (sacroiliac joints and spine), causing stiffness, severe pain and fatigue. In some patients, definitive structural damage of sacroiliac joints is visible on imaging and is known as radiographic axial spondyloarthritis. Some patients do not have a clear radiographic damage of the sacroiliac joints, and this subtype is known as non-radiographic axial spondyloarthritis. Early diagnosis is important for reducing the risk of irreversible structural damage and disability. Management of axial spondyloarthritis is challenging in Saudi Arabia because of inadequate disease knowledge and the unavailability of local guidelines. Therefore, this expert consensus is intended to provide recommendations, including the referral pathway, the definition of remission and the treat-to-target approach, to all healthcare professionals for the management of patients with axial spondyloarthritis. A Delphi technique of consensus was developed by involving an expert panel of 10 rheumatologists, 1 dermatologist and 1 general physician. The experts offered consensus-based recommendations based on a review of available scientific evidence and clinical experience for the referral, screening and management of patients with axial spondyloarthritis.

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Data availability

The datasets of the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors extend their appreciation to the Saudi Society for Rheumatology for their continuous support, and to the Saudi experts for their participation in the Delphi process. The authors are grateful to Dr. Xenofon Baraliakos (Ruhr-University Bochum, Germany) for his independent review of the manuscript. The authors also acknowledge Nancy Zakaria (Novartis, Saudi Arabia) for overall project coordination, and Mihir Pujara and Ramakrishna GS (Novartis, India) for supporting in the literature review process. Our acknowledgement is also extended to Ravneet Kohli and Ramakrishna GS (Novartis, India) for medical writing and editorial assistance in preparing the manuscript.

Funding

This work was supported by Novartis Saudi Limited, Saudi Arabia.

Novartis Saudi Limited,Saudi Arabia

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Authors and Affiliations

  1. Department of Medicine, Prince Sultan Military Medical City, Riyadh, 21577, Saudi Arabia

    Hanan Al Rayes

  2. Department of Rheumatology, Prince Mohammed Medical City, Al Jouf, Saudi Arabia

    Mansour Alazmi

  3. Department of Rheumatology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

    Khaled Alderaan

  4. Department of Rheumatology, University of Bisha, Bisha, Saudi Arabia

    Mushabab Alghamdi

  5. Department of Rheumatology, King Saud Medical City, Riyadh, Saudi Arabia

    Nayef Alghanim

  6. Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia

    Ahmed Alhazmi

  7. Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

    Nadeer Alkhadhrawi

  8. Department of Dermatology, King Saud Bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Mohammad Almohideb

  9. Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia

    Zeyad Alzahrani

  10. Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia

    Mohamed Bedaiwi

  11. Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

    Hussein Halabi

  12. Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Suzan Attar

Authors
  1. Hanan Al Rayes
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  2. Mansour Alazmi
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  3. Khaled Alderaan
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  8. Mohammad Almohideb
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  9. Zeyad Alzahrani
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  10. Mohamed Bedaiwi
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  11. Hussein Halabi
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  12. Suzan Attar
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Contributions

All authors contributed to the study’s conception and design. Data collection and analysis were performed by all authors. All authors approved the final version to be published after critically revising the previous versions of the manuscript.

Corresponding author

Correspondence to Hanan Al Rayes.

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All participants provided consent to the study and agreed to the use of the study results for publication.

Conflict of interest

Zeyad Alzahrani has received an honorarium from Novartis as an advisory member. Hanan Al Rayes, Mansour Alazmi, Khaled Alderaan, Mushabab Alghamdi, Nayef Alghanim, Ahmed Alhazmi, Nadeer Alkhadhrawi, Mohammad Almohideb, Mohamed Bedaiwi, Hussein Halabi and Suzan Attar have nothing to disclose.

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Al Rayes, H., Alazmi, M., Alderaan, K. et al. Expert recommendations on early diagnosis and referral of axial spondyloarthritis in the Kingdom of Saudi Arabia. Clin Rheumatol 41, 991–1002 (2022). https://doi.org/10.1007/s10067-021-06019-5

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  • DOI: https://doi.org/10.1007/s10067-021-06019-5

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