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 J. Nissen, Adrian Ciurea, Burkhard Möller, Lykke Midtbøll Ørnbjerg, Jakub Závada, Bente Glintborg, Alan MacDonald, Karin Laas, Dan Nordström, Björn Guðbjörnsson, Florenzo Iannone, Pasoon Hellmand, Tore K Kvien, Ana Maria Rodrigues, Cătălin Codreanu, Žiga Rotar, Isabel Castrejón Fernández, Johan K. Wallman, Jiří Vencovský, Anne Gitte Loft, Maureen Heddle, Sigrid Vorobjov, Anna‐Mari Hokkanen, Gerður Gröndal, Marco Sebastiani, Marleen van de Sande, Eirik Klami Kristianslund, María José Santos, Corina Mogoşan, Matija Tomšič, Federico Díaz‐González, Daniela Di Giuseppe, Merete Lund Hetland
Abstract
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.