Table 4. Monitoring
Evidence
Quality
a
e ACR conditionally recommends the regular interval use and
monitoring of a validated AS disease activity measure.
Very Low
e ACR conditionally recommends regular interval use and
monitoring of the C-reactive protein (CRP) concentrations or
erythrocyte sedimentation rate (ESR) over usual care without regular
CRP or ESR monitoring.
Very Low
a
See Table 10 for GRADE Scores of Quality of Evidence.
Table 5. Specific Impairments or Comorbidities
Evidence
Quality
a
Advanced hip arthritis
e ACR strongly recommends treatment with total hip arthroplasty over
no surgery.
Very Low
Severe kyphosis
e ACR conditionally recommends against elective spinal osteotomy. Very Low
Acute iritis
e ACR strongly recommends treatment by an ophthalmologist to
decrease the severity, duration, or complications of episodes.
Very Low
Recurrent iritis
e ACR conditionally recommends prescription over no prescription
of topical glucocorticoids for prompt at-home use in the event of eye
symptoms to decrease the severity or duration of iritis episodes.
Very Low
e ACR conditionally recommends treatment with infliximab or
adalimumab over treatment with etanercept to decrease recurrences of iritis.
Very Low
Inflammatory bowel disease
e ACR does not recommend any particular NSAID as the preferred
choice to decrease the risk of worsening of inflammatory bowel disease
symptoms.
Very Low
e ACR strongly recommends using treatment with TNFi monoclonal
antibodies over treatment with etanercept.
Very Low
a
See Table 10 for GRADE Scores of Quality of Evidence.
