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EULAR recommendations

Nadia M T Roodenrijs, Maria J H de Hair, Marlies C van der Goes, Johannes W G Jacobs, Paco M J Welsing, Désirée van der Heijde, Daniel Aletaha, Maxime Dougados, Kimme L Hyrich, Iain B McInnes, Ulf Mueller-Ladner, Ladislav Senolt, Zoltan Szekanecz, Jacob M van Laar, György Nagy
OBJECTIVES: Patients with difficult-to-treat rheumatoid arthritis (RA) remain symptomatic despite treatment according to current European League Against Rheumatism (EULAR) management recommendations. These focus on early phases of the disease and pharmacological management. We aimed to identify characteristics of difficult-to-treat RA and issues to be addressed in its workup and management that are not covered by current management recommendations. METHODS: An international survey was conducted among rheumatologists with multiple-choice questions on disease characteristics of difficult-to-treat RA...
September 7, 2018: Annals of the Rheumatic Diseases
Lisa Schapink, Cornelia H M van den Ende, Laura A H A Gevers, Annelies E van Ede, Alfons A den Broeder
Objectives: To investigate the added value of MTX-HCQ combination therapy (CTG) in early RA in a controlled cohort study. MTX monotherapy (MTG) is recommended as (part of) first choice treatment but no head-to-head comparisons are available comparing MTX-HCQ CTG with MTG. Methods: RA patients from the Sint Maartenskliniek and Radboudumc Nijmegen who started MTX with or without concomitant HCQ from April 2010 to October 2015 were included. The primary outcome was the between-group ΔDAS28-CRP at 6 months, and secondary outcomes were ΔDAS28-CRP at 12 months, EULAR response at 6 and 12 months, and treatment intensification...
September 4, 2018: Rheumatology
Margreet Kloppenburg, Féline Pb Kroon, Francisco J Blanco, Michael Doherty, Krysia S Dziedzic, Elsie Greibrokk, Ida K Haugen, Gabriel Herrero-Beaumont, Helgi Jonsson, Ingvild Kjeken, Emmanuel Maheu, Roberta Ramonda, Marco Jpf Ritt, Wilma Smeets, Josef S Smolen, Tanja A Stamm, Zoltan Szekanecz, Ruth Wittoek, Loreto Carmona
Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options for hand OA published to date. Based on the evidence and expert opinion from an international task force of 19 physicians, healthcare professionals and patients from 10 European countries formulated overarching principles and recommendations...
August 28, 2018: Annals of the Rheumatic Diseases
Iwona Kucybała, Andrzej Urbanik, Wadim Wojciechowski
Current emphasis on diagnosing axial spondyloarthritis (axSpA) in early stage enforced the search for sensitive and specific diagnostic algorithms with the use of imaging methods. The aim of this review was to summarise current recommendations concerning the use of imaging techniques in diagnostics and monitoring of axSpA as well as to outline possible future directions of the development in this field. MEDLINE database was searched between March and April 2018. In the first phase, such keywords were applied: 'ASAS', 'EULAR', 'ASAS-EULAR', 'ASAS/OMERACT', 'axial spondyloarthritis', while in the second step: 'axial spondyloarthritis', 'ankylosing spondylitis', 'magnetic resonance imaging', 'computed tomography', and 'radiography', 'imaging'...
October 2018: Rheumatology International
Lion Vivienne, Schirmer Michael
In 2011 EULAR first published recommendations for the potential role of nurses in the management of patients with rheumatic diseases. To perform a literature update for the role of nurses in the management of chronic inflammatory arthritis (CIA) from 2010 to 2018. A systematic literature review (SLR) was performed according to the PRISMA guidelines, in accordance with the search strategies and eligibility criteria of the EULAR taskforce. The eligibility criteria were "inflammatory arthritis", "interventions undertaken by nurses" and "relevant outcomes to answer the research questions"...
August 20, 2018: Rheumatology International
Yesim Ozguler, Pietro Leccese, Robin Christensen, Sinem Nihal Esatoglu, Dongsik Bang, Bahram Bodaghi, Aykut Ferhat Çelik, Farida Fortune, Julien Gaudric, Ahmet Gul, Ina Kötter, Alfred Mahr, Robert J Moots, Jutta Richter, David Saadoun, Carlo Salvarani, Francesco Scuderi, Petros P Sfikakis, Aksel Siva, Miles Stanford, Ilknur Tugal-Tutkun, Richard West, Sebahattin Yurdakul, Ignazio Olivieri, Hasan Yazici, Gulen Hatemi
Objective: To assess the efficacy and safety of treatment modalities for major organ involvement of Behçet's syndrome (BS), in order to inform the update of the EULAR recommendations for the management of BS. Methods: A systematic literature review of all randomized controlled trials, controlled clinical trials, or open label trials assessing eye, vascular, nervous system or gastrointestinal system involvement of BS was performed. If controlled trials were not available for answering a specific research question, uncontrolled studies or case series were also included...
August 13, 2018: Rheumatology
Evripidis Kaltsonoudis, Eleftherios Pelechas, Paraskevi V Voulgari, Alexandros A Drosos
OBJECTIVES: To estimate the size of unmet needs in the treatment of early Rheumatoid Arthritis (eRA), using all the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or biological DMARDs (bDMARDs) in a long-term observational study. MATERIALS AND METHODS: 538 patients with eRA were evaluated. The 2010 ACR/EULAR classification criteria were used. All patients were csDMARDs and bDMARDs-naive with disease duration less than one year. They were treated according to EULAR and ACR recommendations for RA...
June 22, 2018: Seminars in Arthritis and Rheumatism
Anne-Kathrin Rausch Osthoff, Karin Niedermann, Jürgen Braun, Jo Adams, Nina Brodin, Hanne Dagfinrud, Tuncay Duruoz, Bente Appel Esbensen, Klaus-Peter Günther, Emailie Hurkmans, Carsten Bogh Juhl, Norelee Kennedy, Uta Kiltz, Keegan Knittle, Michael Nurmohamed, Sandra Pais, Guy Severijns, Thijs Willem Swinnen, Irene A Pitsillidou, Louise Warburton, Zhivko Yankov, Theodora P M Vliet Vlieland
Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed...
September 2018: Annals of the Rheumatic Diseases
L Missounga, J Iba Ba, I R Nseng Nseng Ondo, M I C Nziengui Madjinou, D Mwenpindi Malekou, E G Mouendou Mouloungui, J B Boguikouma
OBJECTIVE: to clarify the eligibility criteria for biotherapies in patients with chronic inflammatory rheumatism (CIR) in sub-Saharan Africa and to describe the characteristics of the first 8 patients treated with biotherapy in Gabon. MATERIALS AND METHODS: Patients who responded inadequately to treatments by cDMARDs (EULAR criteria) had a face-to-face interview to inform them about and obtain their consent to biotherapy for at least 3 months, with details of the cost and side effects of each available biotherapy and a certificate of "necessity of biotherapy"...
May 1, 2018: Médecine et Santé Tropicales
Martin I Wah-Suarez, Dionicio A Galarza-Delgado, Jose R Azpiri-Lopez, Iris J Colunga-Pedraza, Jesus Alberto Cardenas-de la Garza, Raymundo Vera-Pineda, Rosa I Arvizu-Rivera, Adrian Martinez-Moreno, Ray E Ramos-Cazares, Elizabeth E Abundis-Marquez, Andres H Guillen-Lozoya, Jose A Davila-Jimenez, Cinthia Y Guillen-Gutierrez, Guillermo Elizondo-Riojas
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in patients with rheumatoid arthritis (RA). Chronic inflammation and traditional risk factors increase cardiovascular risk (CVR) in these patients. Several CVR calculators are used in general population and in RA patients to predict cardiovascular outcomes and tailor therapy but the precision of these calculators in RA patients has yet to be determined. The aim of this study is to determine which risk calculator correlates best with carotid ultrasound (US) findings, specifically carotid plaque (CP) and carotid intima-media thickness (CIMT) in RA patients without clinical manifestations...
September 2018: Clinical Rheumatology
Pietro Leccese, Yesim Ozguler, Robin Christensen, Sinem Nihal Esatoglu, Dongsik Bang, Bahram Bodaghi, Aykut Ferhat Celik, Farida Fortune, Julien Gaudric, Ahmet Gül, Ina Kötter, Alfred Mahr, Robert J Moots, Jutta Richter, David Saadoun, Carlo Salvarani, Francesco Scuderi, Petros P Sfikakis, Aksel Siva, Miles Stanford, Ilknur Tugal-Tutkun, Richard West, Sebahattin Yurdakul, Ignazio Olivieri, Hasan Yazici, Gulen Hatemi
OBJECTIVES: The aim of this systematic review was to inform the update of European League Against Rheumatism (EULAR) Recommendations for the management of Behçet's syndrome (BS), on the evidence for the treatment of skin, mucosa and joint involvement of BS. METHODS: A systematic literature search, data extraction, statistical analyses and assessment of the quality of evidence were performed according to a pre-specified protocol using the PRISMA guidelines. Studies that assessed the efficacy of an intervention in comparison to an active comparator or placebo for oral ulcers, genital ulcers, papulopustular lesions, nodular lesions or arthritis were included...
May 19, 2018: Seminars in Arthritis and Rheumatism
Dario Camellino, Stefano Soldano, Maurizio Cutolo, Marco A Cimmino
The efficacy of tocilizumab (TCZ), a monoclonal antibody to the interleukin (IL)-6 receptor, in suppressing disease activity in glucocorticoid-naïve patients with new-onset polymyalgia rheumatica (PMR) was studied. Its effect on a panel of cytokines and growth factors was evaluated. Three patients, fulfilling the PMR ACR/EULAR criteria, received TCZ at the dosage of 8 mg/kg every 4 weeks for three times followed by prednisone 0.2 mg/kg in case of inefficacy. Concentrations of IL-10, IL-6, tumour necrosis factor (TNF)-α, IL-1β, IL-10, IL-17, interferon (IFN)-γ, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and leukaemia inhibitory factor (LIF) were measured at baseline, after 72 h of the first TCZ infusion and then at weeks 1, 4, 5, 8, 9, 12, 13, 14, 16, and 22...
September 2018: Rheumatology International
Ahmad AlEnizi, Khaled AlSaeid, Adel Alawadhi, Eiman Hasan, Entesar H Husain, Ahmad AlFadhli, Aqeel Ghanem, Fatemah Abutiban, Yaser Ali, Adeeba Al-Herz, Khuloud Mohammed, Waleed Alkandari, Ali Aldei, Hebah Alhajeri, Ahmad Dehrab, Sawsan Hayat
People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years-including the new class of targeted synthetic disease-modifying antirheumatic drugs...
2018: International Journal of Rheumatology
Fouad Fayad, Nelly Ziade, Ghada Abi Karam, Wadih Ghaname, Munther Khamashta
OBJECTIVES: Management of rheumatic diseases (RD) is often problematic in pregnant patients, hence the need for guideline implementation. This survey-based study aimed to assess beliefs among obstetricians and rheumatologists about managing RD in pregnant Lebanese patients. METHODS: Questionnaires were completed by a representative sample of rheumatologists and obstetricians practicing throughout Lebanon. Collected data included physicians' information, opinion on pregnancy in RD patients, compatible drugs with fertility, pregnancy and breastfeeding, references used in their clinical management, referral to specialists, and knowledge about guidelines...
May 24, 2018: Clinical and Experimental Rheumatology
F Buttgereit, T Brabant, H Dinges, I Hiemer, M Kaplani, U Kiltz, D Kyburz, A Reißhauer, M Schneider, C Weseloh, C Dejaco
Polymyalgia rheumatica (PMR) occurs almost exclusively in persons aged 50 years or older and it is the second most common inflammatory rheumatic disease in older people after rheumatoid arthritis. Since there are no specific tests for PMR, the exclusion of clinically similar differential diagnoses is essential to ascertain the diagnosis. These recommendations for the management of PMR assume an already established diagnosis of PMR. It is recommended to initiate treatment with glucocorticoids immediately after diagnosis and to provide appropriate patient information and education about the impact of the disease and its treatment...
June 2018: Zeitschrift Für Rheumatologie
Clément Prati, Céline Demougeot, Xavier Guillot, Maxime Sondag, Frank Verhoeven, Daniel Wendling
Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that involves the entheses, causing inflammatory pain and functional impairments. Patients may experience extraarticular manifestations such as uveitis, psoriasis, and inflammatory bowel disease. These, together with the increased risk of cardiovascular disease and osteoporosis and the development of spinal fusion, are the main determinants of adverse disease outcomes. As with many systemic inflammatory diseases, AS is associated with excess cardiovascular mortality due to increased risks of myocardial infarction, stroke, and venous thromboembolism...
May 19, 2018: Joint, Bone, Spine: Revue du Rhumatisme
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Annals of the Rheumatic Diseases
Hisashi Yamanaka
Clinical Practice Guidelines are statements that include recommendations intended to optimize patient care. In the management of rheumatoid arthritis, many guidelines including ACR/EULAR recommendation, JCR guideline 2014 and number of JCR guidelines for each drug use have been published. The methodology to establish guidelines has been progressed, but work load for the guideline has become incredibly heavy. Legal position of guideline is also to be discussed.
2018: Clinical Calcium
Rinie Geenen, Cécile L Overman, Robin Christensen, Pernilla Åsenlöf, Susana Capela, Karen L Huisinga, Mai Elin P Husebø, Albère J A Köke, Zoe Paskins, Irene A Pitsillidou, Carine Savel, Judith Austin, Afton L Hassett, Guy Severijns, Michaela Stoffer-Marx, Johan W S Vlaeyen, César Fernández-de-Las-Peñas, Sarah J Ryan, Stefan Bergman
Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion...
June 2018: Annals of the Rheumatic Diseases
Francesca Ingegnoli, Tommaso Schioppo, Yannick Allanore, Roberto Caporali, Michele Colaci, Oliver Distler, Daniel E Furst, Nicolas Hunzelmann, Florenzo Iannone, Dinesh Khanna, Marco Matucci-Cerinic
BACKGROUND: Systemic sclerosis (SSc) is an autoimmune chronic disease characterized by vascular impairment, immune dysfunction and collagen deposition. Raynaud's phenomenon (RP) and digital ulcers (DU) are prominent features of SSc. Intravenous (IV) iloprost (ILO), according to the recently updated EULAR recommendations, is indicated for RP after failure of oral therapy. Moreover, IV ILO could be useful in DU healing. IV ILO is currently available mainly on the European market approved for RP secondary to SSc with 3-5 days infusion cycle...
April 4, 2018: Seminars in Arthritis and Rheumatism
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