Objectives In 2007 the EULAR recommendations for the management of early arthritis have been published. In 2010 EULAR also published recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological DMARDs, which were updated in 2013. These later recommendations focussed on the generic pharmacological treatment of RA including Early RA, whereas the 2007 recommendations on early arthritis covered the entire spectrum of the management of early arthritis including also recognition of arthritis, referral, diagnosis, prognosis, classification, information, education, non-pharmacological interventions, and monitoring of the disease process. Between January 2005, when the systematic literature research (SLR) was performed to develop the 2007 recommendations, and 2015 an abundant and rich literature has been published in the field of early arthritis. Taken these points together, it seems important to currently update the EULAR recommendations on early arthritis management.
Methods In accordance with 2014 EULAR Standardised Operating Procedures, the task force pursued an evidence-based approach and an approach based on expert opinion. The task force involved 20 rheumatologists, two patients and one health professional representing 12 European countries. One of them (RL) served as an epidemiologist in order to control the scientific content of the process. The group defined the focus of the task force, the target population, formulated an operational definition of “management” and selected the research questions. A SLR was performed by two fellows (CD, CH) with the help of skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the literature search. For each recommendation the categories of evidence were clearly identified then the strength of the recommendation was derived and level of agreement was determined after voting process.
Results Fifteen research questions, covering the entire spectrum of “management of early arthritis” were formulated. The updated recommendations comprise 3 overarching principles and 12 recommendations for the management of early arthritis. The selected statements included recognition of arthritis, referral, diagnosis, prognostication, imaging, classification, treatment of early arthritis (information, education, non pharmacological interventions, pharmacological treatments, and monitoring of the disease process) as well as strategy. The strength of each recommendation was provided. On the basis of expert opinion, 10 items were identified as being important for future research.
Conclusion These recommendations provide Rheumatologists, General Practitioners, Health professionals, Patients, and other stakeholders with an updated EULAR consensus on the management of patients with early arthritis
Disclosure of Interest None declared
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