IntroductionDespite the availability of axial spondyloarthritis (SpA) recommendations proposed by various rheumatology societies, we considered that a region‐specific guideline was of substantial added value to clinicians of the Asia‐Pacific region, given the wide variations in predisposition to infections and other patient factors, local practice patterns, and access to treatment across countries.Materials and methodsSystematic reviews were undertaken of English‐language articles published between 2000 and 2016, identified from MEDLINE using PubMed, EMBASE and Cochrane databases. The strength of available evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Recommendations were developed through consensus using the Delphi technique.ResultsFourteen axial SpA treatment recommendations were developed based on evidence summaries and consensus. The first 2 recommendations cover non‐pharmacological approaches to management. Recommendations 3 to 5 describe the following: the use of non‐steroidal anti‐inflammatory drugs as first‐line symptomatic treatment; the avoidance of long‐term corticosteroid use; and the utility of conventional synthetic disease‐modifying anti‐rheumatic drugs (csDMARDs) for peripheral or extra‐articular manifestations. Recommendation 6 refers to the indications for biological DMARDs (bDMARDs). Recommendation 7 deals specifically with screening for infections endemic to Asia, prior to use of bDMARDs. Recommendations 7 to 13 cover the role of bDMARDs in the treatment of active axial SpA and include related issues such as continuing therapy and use in special populations. Recommendation 14 deals with the utility of surgical intervention in axial SpA.ConclusionThese recommendations provide up‐to‐date guidance for treatment of axial SpA to help meet the needs of patients and clinicians in the Asia‐Pacific region.

Objective. To investigate associations between continuous treatments with tumor necrosis factor (TNF) antagonists and risk for developing serious infections (SIs

Objective

Abstract

We performed a retrospective chart review of three patients with hypomyopathic dermatomyositis and rapidly progressive interstitial lung disease. The patients were Japanese women of 71, 69, and 65 years of age. Two patients were anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive and 1 was anti-aminoacyl-tRNA synthetase (anti-ARS) antibody-positive. Their respiratory statuses deteriorated despite the administration of glucocorticoid, calcineurin inhibitors, and intravenous cyclophosphamide therapy. We subsequently administered rituximab. The anti-ARS antibody-positive patient survived, while 2 anti-MDA5 antibody-positive patients died.