Recommendations for the management and treatment of ankylosing spondylitis *

Description of the method used for evidence preparationThe members of the Comissão de Espondiloartrites da Sociedade Brasileira de Reumatologia (Commission on Spondyloarthritis of the Brazilian Society of Rheumatology, SBR) 2010–2012 took part in the Evidence Preparation Course given by the Associação Médica Brasileira (Brazilian Medical Association, AMB) in São Paulo in the first semester of 2011. The questions were finally concluded at a meeting of the Commission on Spondyloarthritis held on 15 October 2011 in Florianópolis (SC, Brazil), during the 18th Southern Cone Rheumatology Meeting and were later approved by all the coordinators of the Brazilian Spondyloarthritis Registry. The 15 clinical questions considered to be relevant were structured using the P.I.C.O. method (patient; intervention or indicator; comparison; outcome). The literature search was conducted by searching the databases MEDLINE, EMBASE, SciElo/Lilacs, and the Cochrane Library through February, 2012 (Appendix). Critical assessment of the evidence in the selected articles was performed using the Jadad score. Next, the answers to the questions included in the Recommendations were elaborated, and all the selected references exhibit the corresponding grade of recommendation and strength of scientific evidence. The references were updated through August, 2012, entered into a single file by the coordinator, and sent to the co-authors in two successive rounds for preparation of the final version.Grades of recommendation and strength of evidenceA:Most consistent experimental and observational studies.B:Less consistent experimental and observational studies.C:Case reports (uncontrolled studies).D:Opinion that is not substantiated by critical evaluation, based on consensus, physiological studies or animal models.ObjectiveTo establish recommendations for the management (classification and evaluation criteria by magnetic resonance and genetics) of spondyloarthritis and for the treatment of ankylosing spondyloarthritis.