2018 update of the EULAR recommendations for the management of hand osteoarthritis

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

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

LanguageEnglish
JournalAnnals of the Rheumatic Diseases
DOIs
StateE-pub ahead of print - 28 Aug 2018

Cite this

Kloppenburg, M., Kroon, F. P., Blanco, F. J., Doherty, M., Dziedzic, K. S., Greibrokk, E., ... Carmona, L. (2018). 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases. DOI: 10.1136/annrheumdis-2018-213826
Kloppenburg, Margreet ; Kroon, Féline Pb ; Blanco, Francisco J ; Doherty, Michael ; Dziedzic, Krysia S ; Greibrokk, Elsie ; Haugen, Ida K ; Herrero-Beaumont, Gabriel ; Jonsson, Helgi ; Kjeken, Ingvild ; Maheu, Emmanuel ; Ramonda, Roberta ; Ritt, Marco Jpf ; Smeets, Wilma ; Smolen, Josef S ; Stamm, Tanja A ; Szekanecz, Zoltan ; Wittoek, Ruth ; Carmona, Loreto. / 2018 update of the EULAR recommendations for the management of hand osteoarthritis. In: Annals of the Rheumatic Diseases. 2018
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title = "2018 update of the EULAR recommendations for the management of hand osteoarthritis",
abstract = "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.",
author = "Margreet Kloppenburg and Kroon, {F{\'e}line Pb} and Blanco, {Francisco J} and Michael Doherty and Dziedzic, {Krysia S} and Elsie Greibrokk and Haugen, {Ida K} and Gabriel Herrero-Beaumont and Helgi Jonsson and Ingvild Kjeken and Emmanuel Maheu and Roberta Ramonda and Ritt, {Marco Jpf} and Wilma Smeets and Smolen, {Josef S} and Stamm, {Tanja A} and Zoltan Szekanecz and Ruth Wittoek and Loreto Carmona",
note = "{\circledC} Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2018",
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Kloppenburg, M, Kroon, FP, Blanco, FJ, Doherty, M, Dziedzic, KS, Greibrokk, E, Haugen, IK, Herrero-Beaumont, G, Jonsson, H, Kjeken, I, Maheu, E, Ramonda, R, Ritt, MJ, Smeets, W, Smolen, JS, Stamm, TA, Szekanecz, Z, Wittoek, R & Carmona, L 2018, '2018 update of the EULAR recommendations for the management of hand osteoarthritis' Annals of the Rheumatic Diseases. DOI: 10.1136/annrheumdis-2018-213826

2018 update of the EULAR recommendations for the management of hand osteoarthritis. / Kloppenburg, Margreet; Kroon, Féline Pb; Blanco, Francisco J; Doherty, Michael; Dziedzic, Krysia S; Greibrokk, Elsie; Haugen, Ida K; Herrero-Beaumont, Gabriel; Jonsson, Helgi; Kjeken, Ingvild; Maheu, Emmanuel; Ramonda, Roberta; Ritt, Marco Jpf; Smeets, Wilma; Smolen, Josef S; Stamm, Tanja A; Szekanecz, Zoltan; Wittoek, Ruth; Carmona, Loreto.

In: Annals of the Rheumatic Diseases, 28.08.2018.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - 2018 update of the EULAR recommendations for the management of hand osteoarthritis

AU - Kloppenburg,Margreet

AU - Kroon,Féline Pb

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 Jpf

AU - Smeets,Wilma

AU - Smolen,Josef S

AU - Stamm,Tanja A

AU - Szekanecz,Zoltan

AU - Wittoek,Ruth

AU - Carmona,Loreto

N1 - © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2018/8/28

Y1 - 2018/8/28

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.

U2 - 10.1136/annrheumdis-2018-213826

DO - 10.1136/annrheumdis-2018-213826

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JO - Annals of the Rheumatic Diseases

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JF - Annals of the Rheumatic Diseases

SN - 0003-4967

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Kloppenburg M, Kroon FP, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases. 2018 Aug 28. Available from, DOI: 10.1136/annrheumdis-2018-213826