This fi rst up date of the ASAS/EULAR recommendations on the management of anky lo sing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in de tail and rewor ded if necessary. Decisions on new re com men da tions were made — if necessary after voting. The strength of the recommen dations (SOR) was scored on an 11-point nume rical rating scale after the meeting by email. These recommendations apply to patients of all ages that fulfi ll the modifi ed NY criteria for AS, independent of extra-ar ticu lar manifestations, and they take into ac count all drug and non-drug interventions related to AS. Four overarching principles were introduced, implying that one bullet has been moved to this section. There are now 11 bullet points in clu ding 2 new ones, one related to extra-articular manife sta tions and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good.

/pdf/2010-update-of-the-asas-eular-recommendations-for-the-3t8xq4bpzg.pdf

2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis

2010 Update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis

Objective To develop evidence-based recommendations for the diagnosis of knee osteoarthritis (OA). Methods The multidisciplinary guideline development group, representing 12 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach. For each recommendation, research evidence was searched systematically. Whenever possible, the sensitivity, specificity and likelihood ratio were calculated for individual diagnostic indicators and a diagnostic ladder was developed using Bayes' method. Secondary analyses were undertaken to test directly the recommendations using multiple predictive models in two populations from the UK and the Netherlands. Strength of recommendation was assessed by the EULAR visual analogue scale. Results Recommendations covered the definition of knee OA and its risk factors, subsets, typical symptoms and signs, the use of imaging and laboratory tests and differential diagnosis. Three symptoms (persistent knee pain, limited morning stiffness and reduced function) and three signs (crepitus, restricted movement and bony enlargement) appeared to be the most useful. Assuming a 12.5% background prevalence of knee OA in adults aged >= 45 years, the estimated probability of having radiographic knee OA increased with increasing number of positive features, to 99% when all six symptoms and signs were present. The performance of the recommendations in the study populations varied according to the definition of knee OA, background risk and number of tests applied. Conclusion 10 key recommendations for diagnosis of knee OA were developed using both research evidence and expert consensus. Although there is no agreed reference standard, thorough clinical assessment alone can provide a confident rule-in diagnosis.

https://ard.bmj.com/content/annrheumdis/early/2009/09/17/ard.2009.113100.full.pdf

EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis

Objectives To establish evidence-based recommendations to guide health professionals using intra-articular therapies (IAT) in adult patients with peripheral arthropathies. Methods A multidisciplinary international task force established the objectives, users and scope and the need for background information, including systematic literature reviews) and two surveys addressed to healthcare providers and patients throughout Europe. The evidence was discussed in a face-to-face meeting, recommendations were formulated and subsequently voted for anonymously in a three-round Delphi process to obtain the final agreement. The level of evidence was assigned to each recommendation with the Oxford levels of evidence. Results Recommendations focus on practical aspects to guide health professionals before, during and after IAT in adult patients with peripheral arthropathies. Five overarching principles and 11 recommendations were established, addressing issues related to patient information, procedure and setting, accuracy, routine and special aseptic care, safety issues and precautions to be addressed in special populations, efficacy and safety of repeated joint injections, use of local anaesthetics and aftercare. Conclusion We have developed the first evidence and expert opinion-based recommendations to guide health professionals using IAT. We hope that these recommendations will be included in different educational programmes, used by patient associations and put into practice via scientific societies to help improve uniformity and quality of care when performing IAT in peripheral adult joints.

https://ard.bmj.com/content/annrheumdis/80/10/1299.full.pdf

EULAR recommendations for intra-articular therapies.

Resumen El riesgo de enfermar de tuberculosis ha aumentado en los pacientes con enfermedades inflamatorias cronicas que reciben tratamiento inmunosupresor, en particular en aquellos tratados con terapia anti-TNF (del ingles tumor necrosis factor). En estos pacientes es obligatoria la deteccion de la infeccion tuberculosa latente y el tratamiento de dicha infeccion, dirigido a reducir el riesgo de progresion a enfermedad tuberculosa Este documento de consenso resume la opinion de expertos y los conocimientos actuales sobre tratamientos biologicos, incluidos los bloqueantes del TNF. Se establecen recomendaciones para la utilizacion de las tecnicas de liberacion de interferon-gamma (IGRA) y la prueba de la tuberculina (PT) para el diagnostico y el tratamiento de la infeccion tuberculosa latente.

Documento de consenso sobre la prevención y el tratamiento de la tuberculosis en pacientes candidatos a tratamiento biológico

Objectives: The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of variation in diagnostic and therapeutic performance across disciplines, have found consensus in starting task forces aiming at achieving diagnostic and therapeutic uniformity, and have identified medical conditions with which representatives of both organisations will frequently be confronted in common clinical practice. The aim of the present work was to establish recommendations for the diagnosis and initial management of patients presenting with acute or recent onset swelling of the knee. Methods: The EULAR standard operating procedures for the elaboration and implementation of evidence-based recommendations were followed. Results: In all, 11 rheumatologists from 11 countries and 12 orthopaedic surgeons from 7 countries met twice under the leadership of 2 conveners, a clinical epidemiologist and a research fellow. After carefully defining the content and procedures of the task force, research questions were developed, a comprehensive literature search was performed and the results were presented to the entire committee. Subsequently, a set of 10 recommendations was formulated based on evidence from the literature if available, and after discussion and consensus building. Conclusions: This is the first combined interdisciplinary project of rheumatologists and orthopaedic surgeons, successfully aiming at achieving consensus in the diagnosis and initial management of patients presenting with acute or recent onset swelling of the knee.

https://ard.bmj.com/content/annrheumdis/69/01/12.full.pdf

EULAR/EFORT recommendations for the diagnosis and initial management of patients with acute or recent onset swelling of the knee

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EULAR/EFORT recommendations for the diagnosis and initial management of patients with acute or recent onset swelling of the knee