The Lancet Regional Health. Europe (Oct 2023)
Differences and similarities between the EULAR/ASAS-EULAR and national recommendations for treatment of patients with psoriatic arthritis and axial spondyloarthritis across Europe
- Brigitte Michelsen,
- Mikkel Østergaard,
- Michael John Nissen,
- Adrian Ciurea,
- Burkhard Möller,
- Lykke Midtbøll Ørnbjerg,
- Jakub Zavada,
- Bente Glintborg,
- Alan MacDonald,
- Karin Laas,
- Dan Nordström,
- Bjorn Gudbjornsson,
- Florenzo Iannone,
- Pasoon Hellmand,
- Tore Kristian Kvien,
- Ana Maria Rodrigues,
- Catalin Codreanu,
- Ziga Rotar,
- Isabel Castrejón Fernández,
- Johan Karlsson Wallman,
- Jiri Vencovsky,
- Anne Gitte Loft,
- Maureen Heddle,
- Sigrid Vorobjov,
- Anna-Mari Hokkanen,
- Gerdur Gröndal,
- Marco Sebastiani,
- Marleen van de Sande,
- Eirik Klami Kristianslund,
- Maria José Santos,
- Corina Mogosan,
- Matija Tomsic,
- Federico Díaz-González,
- Daniela Di Giuseppe,
- Merete Lund Hetland
Affiliations
- Brigitte Michelsen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Research Unit, Sørlandet Hospital, Kristiansand, Norway; Corresponding author. Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
- Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Michael John Nissen
- Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland
- Adrian Ciurea
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Burkhard Möller
- Department of Rheumatology and Immunology, Inselspital - University Hospital Bern, Switzerland
- Lykke Midtbøll Ørnbjerg
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Jakub Zavada
- Institute of Rheumatology, Prague, Czech Republic; Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Bente Glintborg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Alan MacDonald
- NHS Grampian, Scotland, UK
- Karin Laas
- Department of Rheumatology, East-Tallinn Central Hospital, Tallinn, Estonia
- Dan Nordström
- Departments of Medicine and Rheumatology, Helsinki University Hospital, Helsinki, Finland
- Bjorn Gudbjornsson
- Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Florenzo Iannone
- Rheumatology Unit, DETO, University of Bari, Italy
- Pasoon Hellmand
- Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Tore Kristian Kvien
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Ana Maria Rodrigues
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal; EpiDoC Unit, Nova Medical School, Lisbon, Portugal; Rheumatology Unit, Hospital dos Lusíadas, Lisbon, Portugal
- Catalin Codreanu
- Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania
- Ziga Rotar
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, Universitiy of Ljubljana, Ljubljana, Slovenia
- Isabel Castrejón Fernández
- Department of Rheumatology, Hospital General, Universitario Gregorio Marañón, Madrid, Spain; Faculty of Medicine, Complutense University of Madrid, Spain
- Johan Karlsson Wallman
- Department of Clinical Sciences Lund, Rheumatology, Skåne University Hospital, Lund University, Lund, Sweden
- Jiri Vencovsky
- Institute of Rheumatology, Prague, Czech Republic; Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Maureen Heddle
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, UK
- Sigrid Vorobjov
- National Institute for Health Development, Tallinn, Estonia
- Anna-Mari Hokkanen
- Department of Medicine, Helsinki University and Helsinki University Hospital, Helsinki, Finland
- Gerdur Gröndal
- Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland
- Marco Sebastiani
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
- Marleen van de Sande
- Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection & Immunity, Amsterdam, the Netherlands; Amsterdam Rheumatology and Immunology Center (ARC), Amsterdam, the Netherlands
- Eirik Klami Kristianslund
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Maria José Santos
- Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal; Instituto Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Portugal
- Corina Mogosan
- Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania
- Matija Tomsic
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, Universitiy of Ljubljana, Ljubljana, Slovenia
- Federico Díaz-González
- Department of Internal Medicine, Dermatology and Psychiatry, Universidad de la Laguna, La Laguna, Spain; Rheumatology Service, Hospital Universitario de Canarias, La Laguna, Spain
- Daniela Di Giuseppe
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Merete Lund Hetland
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Journal volume & issue
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Vol. 33
p. 100706
Abstract
Summary: This is the first report comparing EULAR and national treatment recommendations for PsA patients across Europe, and the first this decade to compare ASAS-EULAR and national treatment recommendations in axSpA patients. An electronic survey was completed from October 2021–April 2022 by rheumatologists in 15 European countries. One and four countries followed all EULAR and ASAS-EULAR recommendations, respectively. Five countries had no national treatment recommendations for PsA and/or axSpA, but followed other regulations. In several countries, national treatment recommendations predated the most recent EULAR/ASAS-EULAR recommendations. Entry criteria for starting biologic/targeted synthetic disease-modifying anti-rheumatic drugs varied considerably. In several countries, for PsA patients with significant skin involvement, interleukin-17 inhibitors were not given preference. The positioning of Janus Kinase inhibitors differed and Phosphodiesterase-4 inhibitors were not in use/reimbursed in most countries. This study may motivate European countries to update their national treatment recommendations, to align them better with the latest international recommendations.
