The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis - 2019

Adv Rheumatol. 2020 Feb 21;60(1):19. doi: 10.1186/s42358-020-0116-2.


Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013.A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed.These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Biological Therapy / methods
  • Biological Therapy / standards*
  • Brazil
  • Exercise
  • Exercise Therapy
  • Glucocorticoids / therapeutic use
  • HLA-B27 Antigen / blood
  • Humans
  • Magnetic Resonance Imaging
  • Patient Education as Topic
  • Prognosis
  • Reproducibility of Results
  • Rheumatology / standards*
  • Sacroiliac Joint
  • Sacroiliitis / diagnosis
  • Societies, Medical / standards*
  • Spine / diagnostic imaging
  • Spondylarthritis* / classification
  • Spondylarthritis* / diagnostic imaging
  • Spondylarthritis* / therapy


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Glucocorticoids
  • HLA-B27 Antigen