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.

Aberdeen Centre for Arthritis and Musculoskeletal Health University of Aberdeen UK

Amsterdam Rheumatology and Immunology Center Amsterdam the Netherlands

Center for Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania

Center for Treatment of Rheumatic and Musculoskeletal Diseases Diakonhjemmet Hospital Oslo Norway

Centre for Rheumatology Research Landspitali University Hospital Reykjavik Iceland

Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Centre for Head and Orthopaedics Rigshospitalet Glostrup Denmark

DANBIO and Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Centre for Head and Orthopaedics Rigshospitalet Glostrup Denmark

Department of Clinical Medicine Aarhus University Aarhus Denmark

Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Department of Clinical Sciences Lund Rheumatology Skåne University Hospital Lund University Lund Sweden

Department of Internal Medicine Dermatology and Psychiatry Universidad de la Laguna La Laguna Spain

Department of Medicine Helsinki University and Helsinki University Hospital Helsinki Finland

Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Rheumatology Aarhus University Hospital Aarhus Denmark

Department of Rheumatology and Clinical Immunology Amsterdam University Medical Center Amsterdam the Netherlands

Department of Rheumatology and Clinical Immunology and Department of Experimental Immunology Amsterdam UMC University of Amsterdam Amsterdam Institute for Infection and Immunity Amsterdam the Netherlands

Department of Rheumatology and Immunology Inselspital University Hospital Bern Switzerland

Department of Rheumatology East Tallinn Central Hospital Tallinn Estonia

Department of Rheumatology Geneva University Hospital Geneva Switzerland

Department of Rheumatology Hospital Garcia de Orta Almada Portugal

Department of Rheumatology Hospital General Universitario Gregorio Marañón Madrid Spain

Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland

Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia

Departments of Medicine and Rheumatology Helsinki University Hospital Helsinki Finland

EpiDoC Unit Nova Medical School Lisbon Portugal

Faculty of Medicine Complutense University of Madrid Spain

Faculty of Medicine Universitiy of Ljubljana Ljubljana Slovenia

Faculty of Medicine University of Iceland Reykjavik Iceland

Institute of Rheumatology Prague Czech Republic

Instituto Medicina Molecular Faculdade de Medicina da Universidade de Lisboa Portugal

National Institute for Health Development Tallinn Estonia

NHS Grampian Scotland UK

Research Unit Sørlandet Hospital Kristiansand Norway

Reuma pt Sociedade Portuguesa de Reumatologia Lisbon Portugal

Rheumatology Service Hospital Universitario de Canarias La Laguna Spain

Rheumatology Unit DETO University of Bari Italy

Rheumatology Unit Hospital dos Lusíadas Lisbon Portugal

Rheumatology Unit University of Modena and Reggio Emilia Modena Italy

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Gossec L., Baraliakos X., Kerschbaumer A., et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020;79:700–712. doi: 10.1136/annrheumdis-2020-217159. PubMed DOI PMC

van der Heijde D., Ramiro S., Landewe R., et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76:978–991. doi: 10.1136/annrheumdis-2016-210770. PubMed DOI

Ogdie A., Coates L.C., Gladman D.D. Treatment guidelines in psoriatic arthritis. Rheumatology. 2020;59:i37–i46. doi: 10.1093/rheumatology/kez383. PubMed DOI PMC

Bergstra S.A., Branco J.C., Vega-Morales D., et al. Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide: results from the METEOR-registry. Ann Rheum Dis. 2018;77:1413–1420. doi: 10.1136/annrheumdis-2018-213289. PubMed DOI

Soriano E.R., Acosta-Felquer M.L., Luong P., Caplan L. Pharmacologic treatment of psoriatic arthritis and axial spondyloarthritis with traditional biologic and non-biologic DMARDs. Best Pract Res Clin Rheumatol. 2014;28:793–806. doi: 10.1016/j.berh.2014.10.011. PubMed DOI

Michelsen B., Georgiadis S., Di Giuseppe D., et al. Real-world six- and twelve-month drug retention, remission, and response rates of secukinumab in 2,017 patients with psoriatic arthritis in thirteen European countries. Arthritis Care Res. 2022;74:1205–1218. doi: 10.1002/acr.24560. PubMed DOI

Lindström U., Di Giuseppe D., Delcoigne B., et al. Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration. Ann Rheum Dis. 2021;80:1410. doi: 10.1136/annrheumdis-2021-220097. PubMed DOI PMC

Harris P.A., Taylor R., Minor B.L., et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95 doi: 10.1016/j.jbi.2019.103208. PubMed DOI PMC

Harris P.A., Taylor R., Thielke R., Payne J., Gonzalez N., Conde J.G. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381. doi: 10.1016/j.jbi.2008.08.010. PubMed DOI PMC

Ramiro S., Nikiphorou E., Sepriano A., et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023;82:19–34. doi: 10.1136/ard-2022-223296. PubMed DOI

van der Heijde D., Aletaha D., Carmona L., et al. 2014 update of the EULAR standardised operating procedures for EULAR-endorsed recommendations. Ann Rheum Dis. 2015;74:8–13. doi: 10.1136/annrheumdis-2014-206350. PubMed DOI PMC

https://www.rheuma-net.ch/fr/informations-d-experts/recommandations-traitement

Braun J., Pham T., Sieper J., et al. International ASAS consensus statement for the use of anti-tumour necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2003;62:817–824. doi: 10.1136/ard.62.9.817. PubMed DOI PMC

Zochling J., van der Heijde D., Burgos-Vargas R., et al. ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2006;65:442–452. doi: 10.1136/ard.2005.041137. PubMed DOI PMC

Orbai A.M., de Wit M., Mease P.J., et al. Updating the psoriatic arthritis (PsA) core domain set: a report from the PsA workshop at OMERACT 2016. J Rheumatol. 2017;44:1522–1528. doi: 10.3899/jrheum.160904. PubMed DOI PMC

van den Berg R., Stanislawska-Biernat E., van der Heijde D.M. Comparison of recommendations for the use of anti-tumour necrosis factor therapy in ankylosing spondylitis in 23 countries worldwide. Rheumatology. 2011;50:2270–2277. doi: 10.1093/rheumatology/ker270. PubMed DOI

Ward M.M., Deodhar A., Gensler L.S., et al. 2019 update of the American College of Rheumatology/Spondylitis Association of America/spondyloarthritis research and treatment Network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2019;71:1599–1613. doi: 10.1002/art.41042. PubMed DOI PMC

Coates L.C., Soriano E.R., Corp N., et al. Group for research and assessment of psoriasis and psoriatic arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022;18:456–479. doi: 10.1038/s41584-022-00798-0. PubMed DOI PMC

Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries