Guías argentinas de práctica clínica, diagnóstico, evaluación y tratamiento en pacientes adultos con espondiloartritis axial
Resumen
La espondiloartritis axial (EspAax) es una enfermedad crónica inflamatoria que incluye a la espondiloartritis radiográfica (EspAax-r) (anteriormente conocida como espondilitis anquilosante [EA]) y a la espondiloartritis axial no radiográfica (EspAax-nr). Los pacientes con EspAax-nr pueden tener compromiso inflamatorio espinal detectado por resonancia magnética (RM) pero, a diferencia de los pacientes con EA, no tienen evidencia de daño estructural radiográfico suficiente para cumplir los criterios de New York modificados. Ambos fenotipos generan un importante impacto en la calidad de vida, el estado global de salud y la productividad laboral si no son tratados en forma oportuna y adecuada. Si bien existen guías de tratamiento para EspAax, como las de la American College of Rheumatology/Spondyloarthritis Research and Treatment Nework (ACR/SPARTAN), de la Panamerican League of Associations of Rheumatology (PANLAR) y del Assessment in SpondyloArthritis International Society/European Alliance of Associations for Rheumatology (ASAS/EULAR), las diferencias clínicas y los diversos contextos socioeconómicos justifican el desarrollo de guías nacionales. En los últimos años se logró un gran avance tanto en el conocimiento de la fisiopatología como en el desarrollo farmacológico para el tratamiento de la EspAax, lo que nos permite tomar decisiones terapéuticas más dirigidas y personalizadas. Hasta el momento, no se han desarrollado guías de recomendaciones para el tratamiento de la EspAax en Argentina. Existe evidencia que muestra que uno de los factores más importantes para la adecuada implementación de las guías en países de bajos ingresos es el esfuerzo para adaptarlas desde la perspectiva de los proveedores de atención médica por lo que consideramos de suma importancia el desarrollo de las mismas localmente. Por lo tanto, el objetivo del Grupo de Estudio de la Sociedad Argentina de Reumatología (SAR) de EspAax y Artritis Reactiva (GESAR EspAax-ARe) fue confeccionar recomendaciones para el manejo terapéutico de pacientes adultos con EspAax en nuestra población.Citas
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