Individual research recommendation details

Recommendation ID

NG65/4

Question

Pharmacological management of peripheral spondyloarthritis:- What is the comparative effectiveness and cost effectiveness of standard DMARDs for managing peripheral spondyloarthritis, and is this effectiveness affected by differences in dose escalation protocols?

Any explanatory notes
(if applicable)

Why this is important:- The committee noted that, although there are a number of randomised controlled trials comparing standard DMARDs with placebo for managing peripheral spondyloarthritis, there is a lack of evidence comparing individual standard DMARDs to other standard DMARDs. This lack of evidence makes it difficult to optimise initial therapy, either by specifying specific drugs within the class or optimising dose, administration and monitoring protocols. There is therefore the need for randomised controlled trials looking at alternative drug, dosing and administration route alternatives for the administration of standard DMARDs for managing peripheral spondyloarthritis. These trials should ensure NSAIDs and steroids are available to participants as needed, and should include (as outcome measures) both health-related quality of life (measured using the EQ-5D) and health service resource use, to enable the results to be used to assess the cost effectiveness of the interventions.

Source guidance details

Comes from guidance

Spondyloarthritis in over 16s: diagnosis and management

Number

NG65

Date issued

February 2017

Other details