TY - JOUR
T1 - 2018 update of the EULAR recommendations for the management of hand osteoarthritis
AU - Kloppenburg, Margreet
AU - Kroon, F. line P. B.
AU - Blanco, Francisco J.
AU - Doherty, Michael
AU - Dziedzic, Krysia S.
AU - Greibrokk, Elsie
AU - Haugen, Ida K.
AU - Herrero-Beaumont, Gabriel
AU - Jonsson, Helgi
AU - Kjeken, Ingvild
AU - Maheu, Emmanuel
AU - Ramonda, Roberta
AU - Ritt, Marco J. P. F.
AU - Smeets, Wilma
AU - Smolen, Josef S.
AU - Stamm, Tanja A.
AU - Szekanecz, Zoltan
AU - Wittoek, Ruth
AU - Carmona, Loreto
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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. Level of evidence, grade of recommendation and level of agreement were allocated to each statement. Five overarching principles and 10 recommendations were agreed on. The overarching principles cover treatment goals, information provision, individualisation of treatment, shared decision-making and the need to consider multidisciplinary and multimodal (non-pharmacological, pharmacological, surgical) treatment approaches. Recommendations 1-3 cover different non-pharmacological treatment options (education, assistive devices, exercises and orthoses). Recommendations 4-8 describe the role of different pharmacological treatments, including topical treatments (preferred over systemic treatments, topical non-steroidal anti-inflammatory drugs (NSAIDs) being first-line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date guidance on the management of hand OA, based on expert opinion and research evidence.
AB - 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. Level of evidence, grade of recommendation and level of agreement were allocated to each statement. Five overarching principles and 10 recommendations were agreed on. The overarching principles cover treatment goals, information provision, individualisation of treatment, shared decision-making and the need to consider multidisciplinary and multimodal (non-pharmacological, pharmacological, surgical) treatment approaches. Recommendations 1-3 cover different non-pharmacological treatment options (education, assistive devices, exercises and orthoses). Recommendations 4-8 describe the role of different pharmacological treatments, including topical treatments (preferred over systemic treatments, topical non-steroidal anti-inflammatory drugs (NSAIDs) being first-line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date guidance on the management of hand OA, based on expert opinion and research evidence.
KW - hand osteoarthritis
KW - treatment
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052871018&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30154087
U2 - https://doi.org/10.1136/annrheumdis-2018-213826
DO - https://doi.org/10.1136/annrheumdis-2018-213826
M3 - Article
C2 - 30154087
SN - 0003-4967
VL - 78
SP - 16
EP - 24
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 1
ER -