Guideline for the diagnosis and treatment of non-radiographic axial spondyloarthritis (2024 edition)

Non-radiographic axial spondyloarthritis (nr-axSpA) is a new term of disease entity, which was introduced in 2009. Nearly ten targeted drugs have been approved for the indication of nr-axSpA abroad, and one drug has also been approved in China. However, in both China and other countries, many doctors, including rheumatologists, are not familiar with the accurate meaning of nr-axSpA. Overdiagnosis or misdiagnosis of nr-axSpA occurs occasionally in both clinical practice and clinical research. Therefore, Chinese Rheumatology Association and Committee for Rheumatologists and Immunologists of Chinese Primary Health Care Foundation convened a task force with the goal of providing an evidence-based guideline for the accurate diagnosis and appropriate treatment of nr-axSpA. The guideline focused on the detailed definitions of axSpA and nr-axSpA, key clues and pitfalls in imaging diagnosis, differential diagnosis, assessing disease activity, long-term outcome, risk factors of radiographic progression, therapeutic principles, non-pharmacological therapy, choices of therapeutic drugs and tapering of drugs, which covered 37 detailed clinical questions.

非放射学中轴型脊柱关节炎（nr-axSpA）是2009年新出现的一种疾病名称，国外已有近十个靶向药物获批nr-axSpA适应证，国内也有一个药物获批。然而，国内外有很多医师（包括风湿科医师）对其准确含义并不熟悉，在临床实践和临床研究中均存在过度诊断/误诊的现象。因此，中华医学会风湿病学分会和中国初级卫生保健基金会风湿免疫学专业委员会牵头组织国内相关领域专家，基于目前的循证医学证据，围绕以下主题进行阐述：疾病概念、影像学诊断要点与注意事项、诊断与鉴别诊断、病情评估、远期转归与不良预后因素、治疗原则、一般治疗、药物治疗与药物减量等，最终基于37个具体临床问题，形成3条总体原则与12条可操作的具体推荐意见，旨在为nr-axSpA的准确诊断和规范治疗提供指导。.