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EULAR recommendations

Sarah Ohrndorf, Aleid C Boer, Debbie M Boeters, Robin M Ten Brinck, Gerd-R Burmester, Marion C Kortekaas, Annette H M van der Helm-van Mil
OBJECTIVE: Ultrasound (US) and magnetic resonance imaging (MRI) are recommended in the diagnostic process of rheumatoid arthritis. Research on its comparability in early disease phases is scarce. Therefore, we compared synovitis and tenosynovitis detected by US and MRI on joint/tendon level. METHODS: Eight hundred forty joints and 700 tendons of 70 consecutive patients, presenting with inflammatory arthritis or clinically suspect arthralgia, underwent US and MRI of MCP (2-5), wrist and MTP (1-5) joints at the same day...
February 14, 2019: Arthritis Research & Therapy
T Kallinich, N Blank, T Braun, E Feist, U Kiltz, U Neudorf, P T Oommen, C Weseloh, H Wittkowski, J Braun
BACKGROUND: Familial Mediterranean fever (FMF) in Germany is a rare, genetically linked disease of childhood and adolescence, which is characterized by recurrent febrile episodes and clinical signs of peritonitis, pleuritis and arthritis. Treatment with colchicine is effective and well-tolerated in the majority of patients; however, some patients do not sufficiently respond to this treatment or are intolerant to colchicine. For these patients first-line treatment with biologics which block interleukin-1 can be used...
January 25, 2019: Zeitschrift Für Rheumatologie
Luca Navarini, Domenico Paolo Emanuele Margiotta, Luisa Costa, Damiano Currado, Marco Tasso, Silvia Angeletti, Massimo Ciccozzi, Raffaele Scarpa, Antonella Afeltra, Francesco Caso
The increased cardiovascular (CV) risk is one of the major challenges in the management of patients with psoriatic arthritis (PsA). Recently, EULAR suggested to adapt the already available CV risk algorithms with a 1.5 multiplication factor in all the patients with rheumatoid arthritis (RA), but it is still uncertain if this adaptation could also be applied to patients with PsA. This study aims to evaluate the performance and calibration of the CV risk algorithm ASSIGN and its adaptations for RA (ASSIGN-RA) and according to EULAR recommendations in a cohort of patients with PsA (ASSIGN*1...
January 24, 2019: Clinical Rheumatology
Thomas Frisell, Mats Dehlin, Daniela Di Giuseppe, Nils Feltelius, Carl Turesson, Johan Askling
Objectives: Current guidelines rank abatacept, rituximab, tocilizumab and TNF-inhibitors (TNFi) as having equal effectiveness for the treatment of RA, at least as second line therapies. These recommendations are mainly based on meta-analysis of randomized controlled trials, with few direct drug-drug comparisons. Our objective was to compare the real-world absolute and relative effectiveness among RA patients starting any of the available biologic DMARDs (bDMARDs). Methods: We used the Swedish Rheumatology Register to identify patients with RA initiating TNFi, rituximab, abatacept or tocilizumab in 2010-2016 as first bDMARD (n = 9333), or after switch from TNFi as first bDMARD (n = 3941)...
January 21, 2019: Rheumatology
Şebnem Ataman, İsmihan Sunar, Gürkan Yilmaz, Hatice Bodur, Kemal Nas, Fikriye Figen Ayhan, Özgür Akgül, Ayşen Akinci, Zuhal Altay, Murat Birtane, Derya Soy Buğdayci, Erhan Çapkin, Remzi Çevik, Yeşim Garip Çimen, M Tuncay Duruöz, Atilla Halil Elhan, Gülcan Gürer, Cahit Kaçar, Ayhan Kamanli, Ece Kaptanoğlu, Taciser Kaya, Hilal Kocabaş, Ömer Kuru, Meltem Alkan Melikoğlu, Sumru Özel, Aylin Rezvani, İlhan Sezer, Fatma Gül Yurdakul
Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items...
September 2018: Archives of Rheumatology
Sonali Wijetilleka, David R Jayne, Chetan Mukhtyar, Aftab Ala, Philip D Bright, Hector Chinoy, Lorraine Harper, Majid A Kazmi, Sorena Kiani-Alikhan, Charles K Li, Siraj A Misbah, Louise Oni, Fiona E Price-Kuehne, Alan D Salama, Sarita Workman, David Wrench, Mohammed Yousuf Karim
Objectives: The association of B cell targeted therapies with development of hypogammaglobulinaemia and infection is increasingly recognized. Our aim was to develop consensus recommendations for immunoglobulin replacement therapy for management of hypogammaglobulinaemia following B cell targeted therapies in autoimmune rheumatic diseases. Methods: A modified Delphi exercise involved a 17-member Taskforce committee, consisting of immunologists, rheumatologists, nephrologists, haematologists, a gastroenterologist, an immunology specialist nurse and a patient representative...
December 26, 2018: Rheumatology
Gulen Hatemi, Emire Seyahi, Izzet Fresko, Rosaria Talarico, Vedat Hamuryudan
New epidemiologic studies from Poland, Jordan, Algeria, Taiwan and Korea highlight the geographic differences in incidence, prevalence and clinical features of Behçet's syndrome (BS). A study from Austria comparing clinical manifestations of their BS patients with different countries of origin suggest that environmental factors may be important in the disease phenotype of BS. New genetic association studies dealing with the innate and acquired aspects of BS prevailed during 2017 and novel susceptibility and regulatory factors were described...
November 2018: Clinical and Experimental Rheumatology
Mariele Gatto, Margherita Zen, Luca Iaccarino, Andrea Doria
The current treatment approach for systemic lupus erythematosus (SLE), as outlined in the recommendations by international medical associations including EULAR and the ACR, is mostly eminence-based rather than evidence-based. However, knowledge on SLE is growing quickly, and such new advances need to be translated into clinical practice. Questions remain regarding the choice and timing of drug administration and tapering until withdrawal, which both can affect the balance between the control of disease activity and damage to organs triggered by long-standing and/or disproportionate immunosuppression...
January 2019: Nature Reviews. Rheumatology
Nienke de Graeff, Noortje Groot, Seza Ozen, Despina Eleftheriou, Tadej Avcin, Brigitte Bader-Meunier, Pavla Dolezalova, Brian M Feldman, Isabelle Kone-Paut, Pekka Lahdenne, Liza McCann, Clarissa Pilkington, Angelo Ravelli, Annet van Royen-Kerkhof, Yosef Uziel, Bas Vastert, Nico Wulffraat, Sylvia Kamphuis, Paul Brogan, Michael W Beresford
Objectives: The European Single Hub and Access point for paediatric Rheumatology in Europe initiative aimed to optimize care for children with rheumatic diseases. Kawasaki disease (KD) is the most common cause of acquired heart disease in children and an important cause of long-term cardiac disease into adulthood. Prompt diagnosis and treatment of KD is difficult due to the heterogeneity of the disease but is crucial for improving outcome. To date, there are no European internationally agreed, evidence-based guidelines concerning the diagnosis and treatment of KD in children...
December 7, 2018: Rheumatology
Helena Marzo-Ortega, Katie M Gaffney, Karl Gaffney
Treat-to-target (T2T) is an emerging treatment paradigm in axial spondyloarthritis (axSpA), originally based on evidence from other inflammatory conditions, which aims to direct therapy to a clear target such as disease remission or low disease activity, with the ultimate goal of maximizing quality of life in affected individuals. The 2016 update of the Assessment of Spondyloarthritis International Society/EULAR guidelines for axSpA have recommended that treatment should be guided according to a predefined target but controversy remains as to what this target should be...
August 1, 2018: Rheumatology
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...
December 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...
January 1, 2019: 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...
January 2019: Annals of the Rheumatic Diseases
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