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EULAR recommendations

Laura C Coates
As in rheumatoid arthritis, treating to target in psoriatic arthritis (PsA) has been shown to improve outcomes over standard therapy. As a result of this, the European League Against Rheumatism (EULAR) updated recommendations for the management of PsA now recommend a treat-to-target approach for all patients with PsA. However, translating the results of this research remains challenging in clinical practice. Prolonged consultation time associated with implementing this into practice can be minimised using a simple to calculate but inclusive target for treatment and assessing this within information technology (IT) systems...
September 2016: Clinical and Experimental Rheumatology
R Agca, S C Heslinga, S Rollefstad, M Heslinga, I B McInnes, M J L Peters, T K Kvien, M Dougados, H Radner, F Atzeni, J Primdahl, A Södergren, S Wallberg Jonsson, J van Rompay, C Zabalan, T R Pedersen, L Jacobsson, K de Vlam, M A Gonzalez-Gay, A G Semb, G D Kitas, Y M Smulders, Z Szekanecz, N Sattar, D P M Symmons, M T Nurmohamed
Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base...
October 3, 2016: Annals of the Rheumatic Diseases
F M Perrotta, E Lubrano
Psoriatic arthritis (PsA) is a chronic inflammatory disease that possibly leads to structural damage and to a reduction of joint function and poor quality of life. Treatment of PsA has changed since its introduction of anti- TNF drugs, which have shown to reduce the symptoms and signs of the disease and slow the radiographic progression. However, recently, the discovery of new pathogenic mechanisms have made possible the development of new molecules that target pro-inflammatory cytokines involved in skin, joint and entheseal inflammation...
2016: Reumatismo
I Cordeiro, A C Duarte, J F Ferreira, M J Gonçalves, T Meirinhos, T M Rocha, V C Romão, S Sousa, M Guedes, M Conde, C Abreu, M J Aleixo, M J Santos
BACKGROUND: Serious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients. OBJECTIVES: To develop evidence-based recommendations for vaccination in SIRD patients. METHODS: We searched MEDLINE (until 31 October 2014) and EMBASE (until 14 December 2014) databases, as well as the ACR and EULAR congress abstracts (2011-2014)...
April 2016: Acta Reumatológica Portuguesa
Maria Antonietta D'Agostino, Lene Terslev, Richard Wakefield, Mikkel Østergaard, Peter Balint, Esperanza Naredo, Annamaria Iagnocco, Marina Backhaus, Walter Grassi, Paul Emery
The absence of specific guidance on how to use ultrasound (US) to diagnose and manage patients with inflammatory arthritis, especially with rheumatoid arthritis (RA) has hindered the optimal utilisation of US in clinical practice, potentially limiting its benefits for patient outcomes. In view of this, a group of musculoskeletal US experts formed a working group to consider how this unmet need could be satisfied and to produce guidance (additional to European League against Rheumatism (EULAR) imaging recommendations) to support clinicians in their daily clinical work...
November 2016: Annals of the Rheumatic Diseases
Krzysztof Bonek, Piotr Głuszko
The current methods of cardiovascular (CV) risk assessment in the course of inflammatory connective tissue diseases are a subject of considerable controversy. Comparing different methods of CV risk assessment in current rheumatoid arthritis (RA) guidelines, only a few of them recommend the use of formal risk calculators. These are the EULAR guidelines suggesting the use of SCORE and the British Society for Rheumatology guidelines performed in collaboration with NICE preferring the use of QRISK-2. Analyzing the latest American and British reports, two main concepts could be identified...
2016: Reumatologia
P Richette, M Doherty, E Pascual, V Barskova, F Becce, J Castañeda-Sanabria, M Coyfish, S Guillo, T L Jansen, H Janssens, F Lioté, C Mallen, G Nuki, F Perez-Ruiz, J Pimentao, L Punzi, T Pywell, A So, A K Tausche, T Uhlig, J Zavada, W Zhang, F Tubach, T Bardin
BACKGROUND: New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations. METHODS: The EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries...
July 25, 2016: Annals of the Rheumatic Diseases
L Andreoli, G K Bertsias, N Agmon-Levin, S Brown, R Cervera, N Costedoat-Chalumeau, A Doria, R Fischer-Betz, F Forger, M F Moraes-Fontes, M Khamashta, J King, A Lojacono, F Marchiori, P L Meroni, M Mosca, M Motta, M Ostensen, C Pamfil, L Raio, M Schneider, E Svenungsson, M Tektonidou, S Yavuz, D Boumpas, A Tincani
OBJECTIVES: Develop recommendations for women's health issues and family planning in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). METHODS: Systematic review of evidence followed by modified Delphi method to compile questions, elicit expert opinions and reach consensus. RESULTS: Family planning should be discussed as early as possible after diagnosis. Most women can have successful pregnancies and measures can be taken to reduce the risks of adverse maternal or fetal outcomes...
July 25, 2016: Annals of the Rheumatic Diseases
B I Gavrilă, C Ciofu, V Stoica
UNLABELLED: Rheumatoid arthritis (RA) is a chronic inflammatory disease with autoimmune pathogenesis. It affects mainly small joints (of the hands and feet) and has many systemic manifestations. Studying biomarkers in rheumatology intensely appeared from the need to understand the mechanisms underlying some rheumatic diseases. Discovering new biomarkers with key roles in various stages of evolution, remains a subject of interest for RA. Currently, according to the EULAR 2010 criteria, the rheumatoid factor (RF) and the anti-cyclic citrullinated peptide (anti-CCP) are used for RA diagnosis...
April 2016: Journal of Medicine and Life
A Reusch, G Musekamp, R Küffner, M Dorn, J Braun, I Ehlebracht-König
Patient education in rheumatology should be evidence-based. As recommended by the European League Against Rheumatism (EULAR) the outcomes of evaluation studies should be based on the goals of the education program. In Germany the goals of education programs have been described for all relevant rheumatological indications, various education programs have been published and evaluated. Our model of patient education outcomes distinguishes proximal and distal outcomes that should be used in effectiveness studies...
July 21, 2016: Zeitschrift Für Rheumatologie
Seiji Nakamura, Katsuya Suzuki, Hiroshi Iijima, Yuko Hata, Chun Ren Lim, Yohei Ishizawa, Hideto Kameda, Koichi Amano, Kenichi Matsubara, Ryo Matoba, Tsutomu Takeuchi
BACKGROUND: According to EULAR recommendations, biologic DMARDs (bDMARDs) such as tumor necrosis factor inhibitor, tocilizumab (TCZ), and abatacept (ABT) are in parallel when prescribing to rheumatoid arthritis (RA) patients who have shown insufficient response to conventional synthetic DMARDs. However, most prediction studies of therapeutic response to bDMARDs using gene expression profiles were focused on a single bDMARD, and consideration of the results from the perspective of RA pathophysiology was insufficient...
2016: Arthritis Research & Therapy
G J Macfarlane, C Kronisch, L E Dean, F Atzeni, W Häuser, E Fluß, E Choy, E Kosek, K Amris, J Branco, F Dincer, P Leino-Arjas, K Longley, G M McCarthy, S Makri, S Perrot, P Sarzi-Puttini, A Taylor, G T Jones
OBJECTIVE: The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. METHODS: A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/non-pharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning...
July 4, 2016: Annals of the Rheumatic Diseases
Laure Gossec, Athan Baillet, Sabrina Dadoun, Claire Daien, Francis Berenbaum, Emmanuelle Dernis, Françoise Fayet, Christophe Hudry, Maryse Mezieres, Sophie Pouplin, Christophe Richez, Alain Saraux, Carine Savel, Eric Senbel, Martin Soubrier, Laëtitia Sparsa, Daniel Wendling, Maxime Dougados
INTRODUCTION: In chronic inflammatory rheumatic diseases (CIRDs), comorbidities such as cardiovascular disease and infections are sub-optimally managed. EULAR recently developed points to consider to collect and report comorbidities. The objective of this present study was to develop a pragmatic guide to collect, report and propose management recommendations for comorbidities, from a rheumatologist perspective. METHODS: The collection and reporting of comorbidities and risk factors was adapted from the EULAR points to consider...
October 2016: Joint, Bone, Spine: Revue du Rhumatisme
M Yates, R A Watts, I M Bajema, M C Cid, B Crestani, T Hauser, B Hellmich, J U Holle, M Laudien, M A Little, R A Luqmani, A Mahr, P A Merkel, J Mills, J Mooney, M Segelmark, V Tesar, K Westman, A Vaglio, N Yalçındağ, D R Jayne, C Mukhtyar
In this article, the 2009 European League Against Rheumatism (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have been updated. The 2009 recommendations were on the management of primary small and medium vessel vasculitis. The 2015 update has been developed by an international task force representing EULAR, the European Renal Association and the European Vasculitis Society (EUVAS). The recommendations are based upon evidence from systematic literature reviews, as well as expert opinion where appropriate...
September 2016: Annals of the Rheumatic Diseases
Thomas Zegkos, George Kitas, Theodoros Dimitroulas
Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality which cannot be fully explained by traditional CV risk factors; cumulative inflammatory burden and antirheumatic medication-related cardiotoxicity seem to be important contributors. Despite the acknowledgment and appreciation of CV disease burden in RA, optimal management of individuals with RA represents a challenging task which remains suboptimal. To address this need, the European League Against Rheumatism (EULAR) published recommendations suggesting the adaptation of traditional risk scores by using a multiplication factor of 1...
June 2016: Therapeutic Advances in Musculoskeletal Disease
Luca Cantarini, Maria L Stromillo, Antonio Vitale, Giuseppe Lopalco, Giacomo Emmi, Elena Silvestri, Antonio Federico, Mauro Galeazzi, Florenzo Iannone, Nicola De Stefano
Behçet's disease (BD) is a multi-systemic disorder of unknown etiology characterized by relapsing oral-genital ulcers, uveitis, and involvement of the articular, gastrointestinal, neurologic, and vascular systems. The choice of treatment is based on the severity of systemic involvement, clinical presentation and the site affected, and includes corticosteroids, azathioprine, interferon, cyclophosphamide, methotrexate or tumor necrosis factor-alpha and interleukin-1 blockers. We present a case series of four refractory BD patients successfully treated with intravenous immunoglobulins (IVIG)...
March 2016: Israel Medical Association Journal: IMAJ
Dionicio A Galarza-Delgado, Jose R Azpiri-Lopez, Iris J Colunga-Pedraza, Jesus A Cardenas-de la Garza, Raymundo Vera-Pineda, Judith I Garcia-Colunga, Rosa I Arvizu-Rivera, Adrian Martinez-Moreno, Jesus Z Villarreal-Perez, Guillermo Elizondo-Riojas, Mario A Garza Elizondo
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in rheumatoid arthritis (RA) patients. Guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA) 2013 and the Adult Treatment Panel III (ATP-III) differ in their strategies to recommend initiation of statin therapy. The presence of carotid plaque (CP) by carotid ultrasound is an indication to begin statin therapy. We aimed to compare the recommendation to initiate statin therapy according to the ACC/AHA 2013 guidelines, ATP-III guidelines, and CP by carotid ultrasound...
May 25, 2016: Clinical Rheumatology
L Mangnus, H W van Steenbergen, M Reijnierse, A H M van der Helm-van Mil
OBJECTIVE: The use of MR-detected inflammation and joint-damage in the diagnostic process of rheumatoid arthritis is recommended by a EULAR-imaging taskforce. This recommendation is based on the sensitivity of MR and not on specificity. Knowledge on the prevalence of MR-detected features in symptom-free persons, however, is pivotal when considering MR for diagnostic purposes. METHODS: From November 2013-December 2014, 196 symptom-free persons from different age categories were recruited from the general population...
May 23, 2016: Arthritis & Rheumatology
Emilia Gvozdenović, Cornelia F Allaart, Désirée van der Heijde, Gianfranco Ferraccioli, Josef S Smolen, Tom W J Huizinga, Robert Landewé
INTRODUCTION: The European League Against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) and the treat-to-target (T2T) principles have been developed in order to improve the treatment outcome of patients with RA, and have received broad attention. It is not clear, though, whether these recommendations are indeed followed up in clinical practice. OBJECTIVE: To investigate if rheumatologists that report to agree with existing guidelines indeed follow them up in clinical practice...
2016: RMD Open
J Braun, A Krause, M Aringer, G Burmester, F Bessler, J-M Engel, U Faubel, R Fischer-Betz, E Genth, E Gromnica-Ihle, B Hellmich, I Kötter, K Krüger, J Lakomek, H-M Lorenz, B Manger, E Märker-Hermann, K Minden, U Müller-Ladner, J Rautenstrauch, S Rehart, G Riemekasten, M Rudwaleit, W Rüther, G Schett, F Schuch, H Schulze-Koops, C Specker, S Wassenberg, D Wiek, A Zink, M Schneider
In a joint initiative by the boards of the German Society for Rheumatology (DGRh) and the Association of Rheumatology Clinics (VRA) the European "standards of care" for rheumatoid arthritis, recently suggested by the European Musculoskeletal Conditions Surveillance and Information Network ( and supported by the European League Against Rheumatism (EULAR), were translated and annotated. The recommendations include aspects of the management of the disease, actual medical care, and access to information - this includes all types of support people with RA need, and, last but not least communication of the necessary knowledge...
May 2016: Zeitschrift Für Rheumatologie
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