2016 update of the EULAR recommendations for the management of early arthritis

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2016 update of the EULAR recommendations for the management of early arthritis

Peripheral inflammatory arthritis is among the most common features with which patients are presented in the rheumatology clinic. Identification of this underlying disease can be difficult and in clinical practice, early inflammatory arthritis is frequently undifferentiated. The European League Against Rheumatism (EULAR) recommendations for the management of early arthritis have been published. In 2010, EULAR presented recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) which was updated in 2013.

Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 EULAR. In accordance with the 2014, EULAR Standardized Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and an expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional who represented the 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of recommendation was proposed based on the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations were derived and the level of agreement was determined through the voting process. An updated EULAR consensus has been provided to the rheumatologists, healthcare professionals, patients and other stakeholders for the management of early arthritis.

The updated recommendations were comprised of 3 overarching principles and 12 recommendations for managing the early arthritis. The selected statements were involved in the recognition of arthritis, referral, diagnosis, prognostication, treatment, monitoring, and strategy. Eighteen items were identified and selected for the future relevance. While these 'recommendations' were deliberately not called guidelines, they do reflect a strong view of many European experts, including patient representatives. Approach to the management of early arthritis has been provided to the rheumatologists, general practitioners, medical students, healthcare professional, health authorities, and patients. Healthcare professional should choose the most appropriate management strategy for individual patient. Although healthcare professional should choose the most appropriate management strategy, still it is hoped that the recommendations will be widely disseminated and discussed within the community of rheumatologists and other healthcare professionals caring for patients with early arthritis. It is believedthat this approach would help improve the standard of care for patients with arthritis across different healthcare systems. Obviously, those recommendations will probably need the amendments after 5 years to incorporate the new scientific evidence.

Source:

BMJ

Link to the source:

http://ard.bmj.com/content/early/2016/12/15/annrheumdis-2016-210602.full.pdf+html

Original title of article:

2016 update of the EULAR recommendations for the management of early arthritis

Authors:

Bernard Combe et al.

BMJ
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