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

Kloppenburg, Margreet; Kroon, Féline P B; Blanco, Francisco J.; Doherty, Michael; Dziedzic, Krysia; Greibrokk, Elsie; Haugen, Ida K.; Herrero‐Beaumont, Gabriel; Jónsson, Helgi; Kjeken, Ingvild; Maheu, E.; Ramonda, Roberta; Ritt, Marco J.P.F.; Smeets, Wilma; Smolen, Josef S; Stamm, Tanja; Szekanecz, Zoltán; Wittoek, Ruth; Carmona, Loreto

doi:10.1136/annrheumdis-2018-213826

Cited by 319 publications

(344 citation statements)

References 68 publications

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“…Rheumatologists were more likely to prescribe topical NSAIDs than nephrologist; given the indication for topical NSAIDs and reason for seeing a rheumatologist, this seems reasonable. Comments recommending use for osteoarthritis and acute musculoskeletal pain are in keeping with current recommendations (Bannuru et al, ; Hochberg et al, ; Kloppenburg et al, ). Interestingly, in those who would advise the use of a topical NSAID, nephrologists seemed less concerned about there use in those with an eGFR <45 mL/min (n: 15/15, 100% vs r: 21/25, 84%), albeit the small response rate may account for such a difference, thus this cannot be generalized.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with oral NSAIDs, they have a reduced systemic absorption with the benefit of a greater overall safety profile (McPherson & Cimino, ). In hand and knee osteoarthritis (OA) they are equally efficacious for pain reduction (Derry et al, ; Tugwell, Wells, & Shainhouse, ), thus are recommended as first line pharmacological therapy (Bannuru et al, ; Hochberg et al, ; Kloppenburg et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Survey of Australasian Renal and Rheumatology Specialists investigating topical NSAID use and adverse renal outcomes

Terrill

Soden

Srivastava

2020

Musculoskeletal Care

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Introduction:A survey investigated physician reported use, prescribing practices and adverse renal events of topical NSAIDs.Method: This survey was sent to members of the Australian Rheumatology Association and the Australian and New Zealand Society of Nephrology.Results: Sixty physicians responded, 55% (n = 33) were nephrologists; 45% (n = 27) rheumatologists.Nearly all (n = 56, 93.3%) had managed at least one patient using topical NSAIDs, including those with an eGFR <45 mL/min (n = 55, 91.7%). Concern was expressed that patients may use topical NSAIDs without the physician's knowledge. The majority (n = 40, 66.6%) have prescribed (or recommended) a topical NSAID, slightly less in patients with a reduced eGFR <45 mL/min (n = 36, 60.0%). Participants would advise topical NSAIDs for osteoarthritis and musculoskeletal pain, though be mindful to monitor the renal function and blood pressure. There was a variance in comments in advising use in CKD (eGFR <45 mL/min) from avoidance in those with an eGFR <30 mL/min to minimal concern. Most respondents (n = 55, 91.7%) had not encountered an acute kidney injury (AKI) suspected from topical NSAID use. Of the five that did, three were thought to be an adverse renovascular event and two were uncertain.All patients had an eGFR <45 mL/min, all had recovery f their renal function with NSAID cessation. Discussion: Patients commonly use topical NSAIDs, often without the physician's knowledge. Most respondents would recommend their use in osteoarthritis and musculoskeletal pain, though with caution in CKD. While an AKI is uncommon due to topical NSAIDs, it may occur, especially in those with CKD. Abstract 2-012: Defining the impact of topical non-steroidal anti-inflammatory drugs on renal function, a survey of Australasian Renal and Rheumatology Specialists. Poster Abstracts. Int J Rheum Dis: 22:40-226.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survey of Australasian Renal and Rheumatology Specialists investigating topical NSAID use and adverse renal outcomes

Terrill

Soden

Srivastava

2020

Musculoskeletal Care

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“…To quantify lesions and for a better follow-up of the disease, Sharp proposed a scoring system of erosions and JSN of hands [86]. The modified Sharp score, proposed by Van der Heijde, included feet, for a total of 16 areas evaluated for erosions and 15 for Diagnostic Challenges and Management Update in Rheumatoid Arthritis DOI: http://dx.doi.org/10.5772/intechopen.91965 JSN in each hand and 6 areas for erosions and six for JSN in each foot [87]. Radiographic progression can redefine remission, as clinically quiet joints often progress.…”

Section: Rheumatoid Arthritis: Imagingmentioning

confidence: 99%

Diagnostic Challenges and Management Update in Rheumatoid Arthritis

Boldeanu¹,

Ionescu²,

Popoviciu³

et al. 2020

Rheumatoid Arthritis - Other Perspectives Towards a Better Practice

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Rheumatoid arthritis is a chronic, systemic inflammatory disease, with certain evidence of multiple factors involved, but also with the strong autoimmune component, leading to a high potential for disability, through synovial inflammation and joint destruction. Diagnostic methods and management possibilities have recently improved, thus leading to a better outcome, based on the treat to target recommendation. Although biologic agents represent efficient therapeutic agents, in the last few years, the advances in understanding the mediators involved in rheumatoid arthritis pathogenesis have provided new targeted therapies, represented by small molecule inhibitors against the Janus kinases that contribute in the signaling pathways of various cytokine receptors.

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“…An unexpected finding was that, in the (small sample of) patients with vitamin D deficiency, the placebo group showed significant greater isokinetic upper leg muscle strength over time compared to the vitamin D group (p = 0.001). (1). Objectives: The main aim was to evaluate whether occupational therapy in the waiting period prior to surgical consultation can reduce or delay the need for surgery in CMC1 OA.…”

Section: Referencesmentioning

confidence: 99%

“…Background: UK guidelines [1][2][3] state that psychological interventions should be offered to people with rheumatoid arthirtis (RA) to help them adjust. Although rheumatology units recognise that providing psychological support is part of their role, 3 in 4 rate their overall provision as inadequate.…”

mentioning

confidence: 99%

Op0159 the Effect of High-Intensity Resistance Training and Vitamin D Supplementation on Muscle Strength in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

et al. 2019

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BackgroundExercise therapy is the cornerstone of knee osteoarthritis (OA) management. In particular muscle strengthening exercise, targeting the characteristic loss of muscle strength present in knee OA, is a key factor for the beneficial effects reported for exercise therapy. The optimal training intensity for resistance training in patients with knee OA, however, is not known to date. Besides resistance training, vitamin D supplementation in patients with vitamin deficiency may optimize muscle strength.ObjectivesTo assess (i) whether high-intensity resistance training leads to greater improvements in muscle strength compared to moderate-intensity resistance training in patients with knee OA; and (ii) whether vitamin D supplementation in combination with strength training leads to greater improvements in muscle strength compared to placebo in combination with strength training in patients with knee OA and vitamin D deficiency (25 (OH)D level > 15 nmol/L and < 50 nmol/L (in winter) or <70 nmol/L (in summer)).MethodsIn a randomized controlled trial, 177 patients with a clinical diagnosis of knee OA were included. All patients were randomly allocated to a high-intensity (70-80% of the Repetition Maximum (1RM)) or a moderate-intensity (40-50% of the 1RM) resistance training program of 12 weeks. Both groups were supervised by a physical therapist twice a week and performed home exercises once a week. In addition, 50 out 177 patients had vitamin D deficiency and received supplementation of vitamin D (1200 IU vitamin D3 per day) or placebo in the 12 weeks prior to and during the resistance training program. The primary outcome measure was isokinetic (60 °/s) upper leg muscle strength (Nm/kg). In addition, the estimated 1 RM for leg press, leg curl and hip abduction were used as measures for muscle strength. Other outcome measures included severity of knee pain (NRS), self-reported and performance based activity limitations (WOMAC physical functioning (WOMAC), Get-up-and-go-test (GUG)). Measurements were performed by a blinded assessor prior to the exercise program (T0), directly after the program (T12) and at 6 months follow-up (T36). Additionally, for patients with vitamin D deficiency, measurements were also taken prior to vitamin supplementation or placebo (T-12).ResultsBoth the high-intensity group and moderate-intensity group improved in upper leg muscle strength over time. No significant differences between groups were found for isokinetic upper leg muscle strength (p = 0.646) (see figure 1). However, when measured by the estimated 1 RM, significant differences were found between groups in favor of the high–intensity group (p = 0.001) (see figure 1). No between-group differences were found on pain (p = 0.885), or on self-reported and performance-based activity limitations (WOMAC p = 0.968; GUG p = 0.800), although both groups improved (see figure 1). An unexpected finding was that, in the (small sample of) patients with vitamin D deficiency, the placebo group showed significant greater isokinetic upper leg muscle ...

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

Cited by 319 publications

References 68 publications

Survey of Australasian Renal and Rheumatology Specialists investigating topical NSAID use and adverse renal outcomes

Survey of Australasian Renal and Rheumatology Specialists investigating topical NSAID use and adverse renal outcomes

Diagnostic Challenges and Management Update in Rheumatoid Arthritis

Op0159 the Effect of High-Intensity Resistance Training and Vitamin D Supplementation on Muscle Strength in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

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