Abstract

Objective: In 2016, ASAS and EULAR made joint recommendations for the management of patients with spondyloarthritis. Although Global and European perspectives are important, they cannot accurately reflect the situation for all patients in all countries and regions. As such, the group worked to tailor the existing international recommendations to suit the specific demographic needs of local populations in the Gulf region, with a specific focus on Kuwait.

Methods: Recommendations drafted following a PubMed search for relevant literature were reviewed and then underwent Delphi vote to reach consensus on those to be included. Advice for newly approved agents, including targeted synthetic disease-modifying anti-rheumatic drugs, was included based on the group's clinical experience.

Results: The resulting 41 recommendations are grouped into five categories covering key definitions and principles for the management and treatment of both axial and peripheral forms of spondyloarthritis.

Conclusion: Through adaptation of existing guidelines and incorporating the current evidence and clinical experience of the members of the group, these recommendations have been developed to reflect the unique situation in Kuwait with regard to differing patient profiles, local culture and approved therapeutic approaches, and are designed to aid in clinical decision-making.

Keywords: ankylosing spondylitis; biological therapy; practice guidelines; psoriatic arthritis; spondyloarthropathy.

Conflict of interest statement

Yaser Ali, Fatemah Abutiban, Adel Alawadhi, Ali AlDei, Ahmad Alenizi, Hebah Alhajeri, Adeeba Al-Herz, Waleed Alkandari, Ahmad Dehrab, Eman Hasan, Sawsan Hayat, Aqeel Ghanem and Khulood Saleh are members of the Kuwaiti Association for Rheumatology. Yaser Ali is employed by the Ministry of Health Kuwait and is a member of KAR. Xenofon Baraliakos has received honoraria from Abbvie, Janssen, Novartis and UCB. He is a Consultant Rheumatology, Clinical Immunology and Allergy, FRCPC, MsC, ABIM. Adel Alawadhi is a Professor and a Consultant Rheumatologist, MD, FRCPC, FACP, FACR. Ali AlDei is a Rheumatology Senior Specialist, MD, FACP. Ahmad Alenizi is a Rheumatologist and the President of the Kuwait Medical Association Kuwait Association of Rheumatology, MD, FRCPC, FACR, MACP. Hebah Alhajeri is a Senior Specialist in Rheumatology, MD, FRCP. Adeeba Al-Herz is a Consultant Rheumatologist and the President of Kuwait Association for Rheumatology, MD, FRCPC, FACP. Waleed Alkandari is a Consultant of internal medicine and rheumatology, MD, FRCP. Fatemah Abutiban is a Consultant medicine and rheumatology, MD, FRCP. Ahmad Dehrab, MBBCh BAO, FACP. Eman Hasan is a Consultant Physician and Rheumatologist, MD, FRCP (UK). Sawson Hayat is a Consultant rheumatologist, MBBCh, MRCP (UK), KBIM, CESR (UK). Aqeel Ghanem is a Rheumatology Consultant and the Head of the Rheumatology Unit, MD, FRCPC. Khulood Saleh is a Consultant rheumatologist, FRCPc. Xenofon Baraliakos is an Associate Professor, MD. The authors report no conflicts of interest in this work.