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EULAR recommendations

Féline P B Kroon, Loreto Carmona, Jan W Schoones, Margreet Kloppenburg
To update the evidence on efficacy and safety of non-pharmacological, pharmacological and surgical interventions for hand osteoarthritis (OA), a systematic literature review was performed up to June 2017, including (randomised) controlled trials or Cochrane systematic reviews. Main efficacy outcomes were pain, function and hand strength. Risk of bias was assessed. Meta-analysis was performed when advisable. Of 7036 records, 127 references were included, of which 50 studies concerned non-pharmacological, 64 pharmacological and 12 surgical interventions...
2018: RMD Open
Christina Ryser, Adrian Ciurea
Therapy of Psoriasis Arthritis Taking into Account New Treatment Options Abstract. Psoriatic arthritis occurs in about 20-30 % of patients with psoriasis. The disease is heterogeneous and can involve a variety of the distinct anatomical sites. The choice of medication depends on the type and the severity of clinical features. The recommendations of EULAR and GRAPPA serve as a guide for the choice of medication, which is used in sequential treatment steps. This is presented in our review in usable, simplified terms...
2018: Praxis
Claire Daien, Charlotte Hua, Cécile Gaujoux-Viala, Alain Cantagrel, Madeleine Dubremetz, Maxime Dougados, Bruno Fautrel, Xavier Mariette, Nathalie Nayral, Christophe Richez, Alain Saraux, Gérard Thibaud, Daniel Wendling, Laure Gossec, Bernard Combe
The 2014 French Society for Rheumatology (Société Française de Rheumatologie, SFR) recommendations about the management of rheumatoid arthritis (RA) have been updated by a task force composed of 12 expert rheumatologists, 2 patient self-help group representatives, and an occupational therapist. The material used by the task force included recent EULAR recommendations, a systematic literature review, and expert opinion. Four general principles and 15 recommendations were developed. The general principles emphasize the need for shared decision-making between the rheumatologist and the patient and for a global management program including both pharmacological and nonpharmacological treatments...
October 10, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Luca Navarini, Domenico Paolo Emanuele Margiotta, Francesco Caso, Damiano Currado, Marco Tasso, Silvia Angeletti, Massimo Ciccozzi, Raffaele Scarpa, Antonella Afeltra, Luisa Costa
INTRODUCTION: In patients with psoriatic arthritis (PsA) an increased cardiovascular (CV) risk has been observed. Recently, a EULAR taskforce suggested to use a multiplication by the factor of 1.5 of CV risk algorithms in patients with inflammatory arthritis. This study aims to evaluate the performance of five original and adapted according to EULAR recommendations CV risk algorithms in PsA: SCORE, CUORE, Framingham Risk Score (FRS), QRISK2, and Reynold's Risk Score (RRS). METHODS: Prospectively collected data from two Italian cohorts were used...
2018: PloS One
K V Guggenberger, Thorsten Alexander Bley
The role of imaging in diagnosis and monitoring of vasculitides has steadily become more important during the last years. As a result of the technological progress, its low invasiveness and its relatively good diagnostic reliability, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) are increasingly used in the assessment of vasculitic changes of extra- and intra-cranial arteries. The aim of this review is to outline the significance of different imaging modalities, particularly the significance of MRI/MRA, in the context of large-vessel vasculitides, especially in regard to the first EULAR (The European League Against Rheumatism)-recommendations on the role of imaging in the process of diagnosis and monitoring of patients with suspected large-vessel vasculitides...
September 2018: Clinical and Experimental Rheumatology
Monica Todoerti, Ennio Giulio Favalli, Florenzo Iannone, Ignazio Olivieri, Maurizio Benucci, Alberto Cauli, Alessandro Mathieu, Leonardo Santo, Giovanni Minisola, Giovanni Lapadula, Romano Bucci, Elisa Gremese, Roberto Caporali
Objective: To establish evidence-based and experts' opinion filtered statements on the optimal treatment choice between cycling (switch) and changing mode of action strategies (swap) in RA patients failing TNF inhibitors (TNFis). Methods: The relevant question (switch vs swap) was rephrased into a research question according to the population, intervention, comparison and outcome (PICO) strategy, considering all the available scientific evidence published from the 2013 EULAR set of recommendations up to mid-January 2016...
October 1, 2018: Rheumatology
Alessandra Bortoluzzi, Guido Valesini, Salvatore D'Angelo, Bruno Frediani, Laura Bazzichi, Antonella Afeltra, Giuseppe Paolazzi, Andrea Doria, Pier Luigi Meroni, Marcello Govoni
Objective: To establish clinical consensus for the optimal placement of TNF inhibitor (TNFi) in DMARDs-naïve RA patients. Methods: The steering group was composed of 15 Italian rheumatologists expert in the field of RA, who proposed and selected by consensus the clinically relevant questions on the role of TNFi treatment in DMARDs-naïve RA patients. The question was rephrased according to the population, intervention, comparison and outcome statement. The available scientific evidence on this topic were collected by updating the systematic literature reviews used for the EULAR 2013 recommendations up to January 2016...
October 1, 2018: Rheumatology
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"...
November 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
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