Efficacy and Safety of Non-Pharmacological and Non-Biological Interventions: A Systematic Literature Review Informing the 2022 Update of the ASAS/EULAR Recommendations for the Management of AxSpA

Non-pharmacological interventions are important for any rheumatic disease, but especially axSpA, where they represent the cornerstone of treatment. The aim of this study was to produce a systematic literature review on efficacy and safety of non-pharmacological and non-biological pharmacological treatments was performed.

In addition, NSAIDs were also confirmed to be efficacious in axSpA. Alendronate is not effective in axSpA, while limited efficacy of short-term use of high-dose glucocorticoids has been shown. Among tsDMARDs, filgotinib, tofacitinib, and upadacitinib have shown efficacy in radiographic axSpA, with an acceptable short-term safety profile.