Volume 34, Issue 3, September 2023

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Mediterr J Rheumatol 2023;34(2):139-51
Recommendations of the Moroccan Society of Rheumatology (SMR) for the Therapeutic Management of Spondyloarthritis (SpA) including Psoriatic Arthritis (PsA)
Authors Information

1Department of Rheumatology A, El Ayachi Hospital, Ibn Sina University Hospital, Salé, Morocco

2Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco

3Private Medical Office of Rheumatology, Rabat, Morocco

4Mohamed V University, Rabat, Morocco

5Department of Rheumatology, Military Hospital Avicenne, Mohammed VI University Hospital, Marrakech, Morocco

6Department of Rheumatology, Arrazi University Hospital, Marrakech, Morocco

7Private Medical Office, Rabat, Morocco

8Department of Rheumatology, Mohammed VI University Hospital, Oujda, Morocco

9Department of Rheumatology, Ibn Rochd University Hospital, Casablanca, Morocco

10 Department of Rheumatology, Tanger-Tetouan- Al Hoceima University Hospital, Tanger, Morocco

11Department of Rheumatology, Hassan II University Hospital, Fez, Morocco

12 Department of Rheumatology, Hassan II Hospital, CHU Souss Massa, Agadir, Morocco

13CARBONE Research Team, LARISS Laboratory, FMPA, Ibn Zohr University, Agadir, Morocco

14 Department of Physical Medicine and Rehabilitation, El Ayachi Hospital, Ibn Sina University Hospital, Salé, Morocco

15Laboratory of Clinical Research and Epidemiology, Faculty of Medicine, Mohammed V University, Rabat, Morocco

16Department of Medicine, Health Science College, International University of Rabat (UIR), Rabat, Morocco


The advent of new therapeutic classes and the updating of international recommendations have justified the development of recent recommendations by the Moroccan Society of Rheumatology. Methods: Guidelines were drafted by a core steering committee after performing a literature search. A multidisciplinary task force, including three fellows, eleven rheumatologists, a specialist in physical medicine and rehabilitation, an epidemiologist from hospital-university, hospital, and liberal sectors and one patient assessed the Best Practice Guidelines using 2 rounds of anonymous online voting by modified Delphi process. Thus, 19 recommendations were developed. Recommendation 1 concerns the therapeutic principles, Recommendation 2 insists on the information and education of the patient, Recommendation 3 concerns the general measures to be adopted, namely physical activity, smoking cessation and psychological support, Recommendation 4 concerns Non-Steroidal Anti-Inflammatory Drugs which constitute the first-line treatment, Recommendations 5 to 7 concern the use of analgesics, of general and local corticosteroid therapy and conventional synthetic disease-modifying antirheumatic drugs, Recommendations 8 to 13 deal with the use of biologic agents, including new classes and their indications in radiographic and non-radiographic axial and peripheral spondyloarthritis, follow-up and management in case of failure or remission, Recommendation 14 deals with the indication for Janus kinase inhibitors drugs, Recommendation 15 deals with physical treatment, and Recommendation 16 deals with the indication of surgery. Recommendations 17-19 deal with special situations, namely fibromyalgia, vaccination, and pregnancy. A well-defined therapeutic strategy with first- and second-line treatments has been established.

Cite this article as: Jaouad N, Oulkadi L, Bentaleb I, Bezza A, El Maghraoui A, Niamane R, El Bouchti I, Larhrissi S, Ichchou L, Janani S, Abourazzak FE, Akasbi N, Erraoui M, Karkouri S, Hmamouchi I, Bahiri R. Recommendations of the Moroccan Society of Rheumatology (SMR) for the Therapeutic Management of Spondyloarthritis (SpA) including Psoriatic Arthritis (PsA). Mediterr J Rheumatol 2023;34(2):139-51.

Article Submitted: 17 Oct 2022; Revised Form: 01 Jun 2023; Article Accepted: 04 Jun 2023; Available Online: 30 Jun 2023


This work is licensed under a Creative Commons Attribution 4.0 International License.

©2023 The Author(s).