Academic literature on the topic 'EULAR recommendation'
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Journal articles on the topic "EULAR recommendation"
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van der Heijde, Désirée, Sofia Ramiro, Robert Landewé, et al. "2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis." Annals of the Rheumatic Diseases 76, no. 6 (2017): 978–91. http://dx.doi.org/10.1136/annrheumdis-2016-210770.
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To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009. After a discussion of the results in the steering group and presentation to the task force, overarching principles and recommendations were formulated, and consensus was obtained by informal voting. A total of 5 overarching principles and 13 recommendations were agreed on. The first three recommendations deal with personalised medicine including treatment target and monitoring. Recommendation 4 covers non-pharmacological management. Recommendation 5 describes the central role of non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice drug treatment. Recommendations 6–8 define the rather modest role of analgesics, and disprove glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for axSpA patents with predominant axial involvement. Recommendation 9 refers to biological DMARDs (bDMARDs) including TNFi and IL-17 inhibitors (IL-17i) for patients with high disease activity despite the use (or intolerance/contraindication) of at least two NSAIDs. In addition, they should either have an elevated C reactive protein and/or definite inflammation on MRI and/or radiographic evidence of sacroiliitis. Current practice is to start with a TNFi. Switching to another TNFi or an IL-17i is recommended in case TNFi fails (recommendation 10). Tapering, but not stopping a bDMARD, can be considered in patients in sustained remission (recommendation 11). The final two recommendations (12, 13) deal with surgery and spinal fractures. The 2016 Assessment of SpondyloArthritis international Society-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
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Kloppenburg, Margreet, Féline PB Kroon, Francisco J. Blanco, et al. "2018 update of the EULAR recommendations for the management of hand osteoarthritis." Annals of the Rheumatic Diseases 78, no. 1 (2018): 16–24. http://dx.doi.org/10.1136/annrheumdis-2018-213826.
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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.
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Zhang, W., M. Doherty, E. Pascual, et al. "EULAR recommendations for calcium pyrophosphate deposition. Part II: Management." Annals of the Rheumatic Diseases 70, no. 4 (2011): 571–75. http://dx.doi.org/10.1136/ard.2010.139360.
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ObjectivesTo develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD).MethodsA multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically. Whenever possible, the effect size and number needed to treat for efficacy and RR or OR for side effects were calculated for individual treatment modalities. Strength of recommendation was assessed by the European League Against Rheumatism visual analogue scale.ResultsNine key recommendations were generated, including topics for general management, treatment of acute attacks, prophylaxis against recurrent acute attacks and management of chronic symptoms. It was recommended that optimal treatment requires both non-pharmacological and pharmacological treatments. For acute CPP crystal arthritis, cool packs, temporary rest and joint aspiration combined with steroid injection are often sufficient. For prophylaxis or chronic inflammatory arthritis with CPPD, oral non-steroidal anti-inflammatory drugs with gastroprotective treatment and/or low-dose colchicine 0.5–1.0 mg daily may be used. Other recommendations included parenteral or oral corticosteroid for acute CPP arthritis in those unresponsive or unsuited to other measures, and low-dose corticosteroid, methotrexate or hydroxychloroquine for chronic inflammatory arthritis with CPPD. Asymptomatic CPPD requires no treatment. Strength of recommendations varies from 79% to 95%.ConclusionNine key recommendations for management of CPP crystal associated arthritis were developed using both research evidence and expert consensus. Strength of recommendations was provided to assist the application of these recommendations.
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Radak-Perovic, Marija, and Mirjana Zlatkovic-Svenda. "Quality of treatment in gouty patients considering EULAR recommendations." Srpski arhiv za celokupno lekarstvo 140, no. 11-12 (2012): 717–21. http://dx.doi.org/10.2298/sarh1212717r.
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Introduction. There are 12 recommendations for gout treatment, based on evidence and opinion of experts. Objective. To assess the quality of therapy in patients with gout analyzing adherence to four selected recommendations. Methods. Retrospective cross sectional study of 111 patients with gouty flare was conducted. Adherence to selected recommendation was defined as odds ratio between the number of patients whose therapy adhered to treatment recommendation and the number of patients eligible for the relevant recommendation. These recommendations refer to indications for allopurinol treatment (R1), prophylaxis of induced gouty flares in the first month of allopurinol treatment (R2), treatment goals (R3), and treatment monitoring regime (R4). Results. Out of 111 patients with gout, 25 with tophi, 87 with frequent gouty flares and 46 with CUA or X-ray erosions were indicated for allopurinol treatment. The adherence to R1 was 76% for tophi patients, 54% for patients with frequent gouty flares, and 63% for patients with CUA. None of the patients starting allopurinol was either recruited for gouty prophylaxis or monitored properly; adherence to R2 as well as to R4 was 0%. Target serum uric acid (SUc) rating below 360 ?mol/L was achieved in 13/50 patients treated with allopurinol, while the adherence to R3 was 26%. Therapeutic monitoring in accordance with P4 was not done in any of the patients on allopurinol. There were no differences in mean levels of the SUc between allopurinol users and non-users: 471.3?164.4 vs. 460.0?103.5 ?mol/L (p=0.067). Therefore, almost every second patient with gouty flares was on allopurinol therapy (50/111). Conclusion. The degree of deviation in relation to the key principles of correct treatment in patients with gout ranged from a relatively high (24%) to that of absolute digression (100%).
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Uson, Jacqueline, Sebastián Cruz Rodriguez-García, Raul Castellanos-Moreira, et al. "EULAR recommendations for intra-articular therapies." Annals of the Rheumatic Diseases 80, no. 10 (2021): 1299–305. http://dx.doi.org/10.1136/annrheumdis-2021-220266.
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ObjectivesTo establish evidence-based recommendations to guide health professionals using intra-articular therapies (IAT) in adult patients with peripheral arthropathies.MethodsA 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.ResultsRecommendations 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.ConclusionWe 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.
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Vivienne, Lion, and Schirmer Michael. "Nurses’ roles in the management of chronic inflammatory arthritis: a systematic review." Rheumatology International 38, no. 11 (2018): 2027–36. http://dx.doi.org/10.1007/s00296-018-4135-9.
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Abstract In 2011 EULAR first published recommendations for the potential role of nurses in the management of patients with rheumatic diseases. To perform a literature update for the role of nurses in the management of chronic inflammatory arthritis (CIA) from 2010 to 2018. A systematic literature review (SLR) was performed according to the PRISMA guidelines, in accordance with the search strategies and eligibility criteria of the EULAR taskforce. The eligibility criteria were “inflammatory arthritis”, “interventions undertaken by nurses” and “relevant outcomes to answer the research questions”. Exclusion criteria were in itself contradictory outcomes, insufficient data, consideration if they did not clearly distinguish between nurses and health professionals or focused on chronic other than rheumatic diseases. Systematic reviews were classified as descriptive and excluded. Quality of selected trials was determined according to Oxford—levels of evidence 2009. A total of 48 articles and 10 abstracts were identified fulfilling the eligibility and exclusion criteria. Recommendation 1 has been well established in Europe so far. New evidence strengthens the recommendation 3, and—at least in part—recommendation 6. High evidence strengthens recommendation 4, especially for outpatients with low and stable disease activity. Some new evidence also exists for recommendations 7 and 8. This SLR reveals new evidence for the role of nurses in managing CIA patients since 2010, especially for RA-patients with low disease activity or in remission.
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Zhang, W., M. Doherty, G. Peat, et al. "EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis." Annals of the Rheumatic Diseases 69, no. 3 (2009): 483–89. http://dx.doi.org/10.1136/ard.2009.113100.
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ObjectiveTo develop evidence-based recommendations for the diagnosis of knee osteoarthritis (OA).MethodsThe 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.ResultsRecommendations 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.Conclusion10 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.
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Nurmohamed, M. "SP0033 Eular Recommendation Update on Cardiovascular Disease in RA." Annals of the Rheumatic Diseases 74, Suppl 2 (2015): 9.1–9. http://dx.doi.org/10.1136/annrheumdis-2015-eular.6614.
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Bitik, B., M. E. Tezcan, and A. E. Yucel. "AB1418 A SYSTEMATIC REVIEW OF CURRENT RHEUMATOLOGY GUIDELINES FOR GERIATRIC PERSPECTIVES." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1814.2–1815. http://dx.doi.org/10.1136/annrheumdis-2022-eular.4931.
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BackgroundGeriatric population (GP) includes people over 65 years of age. GP can also be divided into the 65-75 age group and >75 age group. In the last 50 years, the proportion of the elderly in the society has increased (1). Meanwhile, GP has higher frequency of rheumatological disorders. While managing the treatment of this special patient group, some physiological differences of the elderly should be considered. Elderly patients are at increased risk for adverse drug reactions as a result of age-related changes in pharmacokinetics and pharmacodynamics. Polypharmacy is contributing to increased risk of clinically significant drug interactions. In addition, alterations in cognitive functions may impair drug compliance. On the other hand, clinicians may hesitate to apply more effective treatment due to safety concerns. (2).Rheumatologists should be aware of the problems they may encounter when planning the treatment of this privileged group.ObjectivesWe reviewed rheumatology guidelines to assess rheumatology organizations’ perspective on GP.MethodsGuidelines published by EULAR, ACR and the British Society for Rheumatology (BSR) for adult patients from 1970-2022 were reviewed by two rheumatologists to assess the existence of specific recommendations for the treatment of adult patients over 65 years of age.ResultsIn total, 58 guidelines were reviewed. None of the guidelines grouped patients by age. Seven (12%) guidelines had recommendations or statements about elderly patients (Table 1). As we observe, there are no satisfactory recommendations for the GP with rheumatological diseases. The most propable reason for this result is the lack of studies in the rheumatology literature to lead to guideline recommendations.Table 1.Characteristics of guidelines reviewedNumber of guidelines (n)Guidelines with specific recommandation for GPEULAR381-2-3-4-5-6ACR116BSR971EULAR points to consider for the management of difficult-to-treatrheumatoidarthritis(recommendation 6)2. Points to consider for the development, evaluation and implementation of mobile health applications for self-management in patients with rheumaticdiseases (points to consider 8)3. 2019 update of EULAR recommendations for Vaccination in AdultPatientswithAutoimmuneInflammatoryRheumatics4. EULAR Recommendations for prevention and management of osteoporoticfractures(recommendation 6)5. EULAR Points to consider for monitoring (detection/prevention) comorbidities in inflammatoryrheumaticdiseases (point to consider 10)6. 2015 Recommendations for the management of polymyalgiarheumatica: a European League AgainstRheumatism/American College of Rheumatologycollaborativeinitiative (recommendation 9)7. BSR guidelines for the management of polymyalgiarheumatica (recommendation 6)ConclusionCurrent prominent rheumatology guidelines have insufficiently addressed the management of rheumatological diseases in GP. Additional studies ares needed to delineate specific guidelines for the management of geriatric patients with rheumatological diseases.References[1]OECD (2022), Elderlypopulation (indicator). doi: 10.1787/8d805ea1-en (Accessed on 27 January 2022)[2]Tutuncu Z, Reed G, Kremer JA. Do patients with older-onsetrheumatoidarthritisreceive less aggressivetreatment? Ann Rheum Dis. 2006 Sep;65(9):1226-9.Disclosure of InterestsNone declared
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Ma, Ling, Yan Liang, Sheng-nan Yu, et al. "Assessment of the practicability of implementing the EULAR recommendations for the role of nurses in the management of chronic inflammatory arthritis in China." European Journal of Inflammation 18 (January 2020): 205873922093522. http://dx.doi.org/10.1177/2058739220935225.
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Chronic inflammatory arthritis (CIA) severely impacts quality of life in over 100 million people in China. In 2011, the European League Against Rheumatism (EULAR) developed recommendations for the role of nurses in the management of CIA. However, it remains unknown whether these recommendations could be fully implemented in China. Therefore, we aimed to solve the problem in this study. We conducted a nationwide cross-sectional study among 485 nurses in rheumatology and immunology departments based on an online questionnaire. The agreement of the recommendations by the subjects and the feasibility of the recommendations they believe were assessed by visual analogue scale (VAS). Our results showed that over 80% of the subjects agreed with each recommendation (VAS 5–10), and over 80% of the subjects considered the recommendations feasible (VAS 5–10). This study indicates that the EULAR recommendations can also be well implemented in China.
Books on the topic "EULAR recommendation"
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Passalent, Laura, and Salih Ozgocmen. Non-pharmacological management in axial spondyloarthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198734444.003.0019.
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The ASAS/EULAR panel recommends a multidisciplinary and patient-centred approach that includes a combination of pharmacological and non-pharmacological treatment modalities. These updated recommendations describe a number of non-pharmacological interventions as the cornerstone of treatment in patients with ankylosing spondylitis (AS). The aims of such treatment are to: (1) reduce pain and discomfort; (2) maintain or improve muscle strength, endurance, flexibility, mobility, balance, physical fitness, and social participation; and (3) prevent spinal abnormalities, joint contractures, and deformities. This chapter presents the evidence in support of common non-pharmacological interventions for axial spondyloarthritis (axSpA) and provides recommendations regarding the implementation of such treatment strategies.
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Rudwaleit, Martin. Enthesitis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0054.
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Enthesitis is one of the key manifestations of spondyloarthritides (SpA) including ankylosing spondylitis (AS) and psoriatic arthritis. Enthesitis can occur alone or in combination with peripheral arthritis, sacroiliitis, or spondylitis. The inflammatory process is typically located at the insertion of the enthesis or ligament to bone, often resulting in osteitis as well. Because of its anatomical and functional complexity the term 'enthesis organ' has been coined. Biomechanical stress applied to the enthesis seems to play an important role for the occurrence of enthesitis in genetically predisposed individuals. Ultrasound imaging of peripheral entheses reveals enthesis abnormalities including entheseal calcification, bony erosion, or bony proliferation. Power Doppler signals demonstrating increased vascularization of inflamed entheses at the insertional site appear to be the most characteristic finding for enthesitis, yet study results are conflicting. Enthesitis-related osteitis and enthesitis at the spine is best visualized by MRI. Enthesitis may resolve spontaneously or may run a chronic course. Standard treatment includes local steroid injections, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. There is little evidence for the efficacy of disease-modifying anti-rheumatic drugs (DMARDs) in enthesitis. In contrast, anti-TNF agents have proven efficacy, and their use in treatment-resistant enthesitis is recommended in the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of AS and axial SpA and in the EULAR recommendations for psoriatic arthritis.
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Rudwaleit, Martin. Enthesitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0054_update_002.
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Enthesitis is one of the key manifestations of spondyloarthritis (SpA) including ankylosing spondylitis (AS) and psoriatic arthritis. Enthesitis can occur alone or in combination with peripheral arthritis, sacroiliitis, or spondylitis. The inflammatory process is typically located at the insertion of the enthesis or ligament to bone, often resulting in osteitis as well. Because of its anatomical and functional complexity the term ’enthesis organ’ has been coined. Biomechanical stress applied to the enthesis seems to play an important role for the occurrence of enthesitis in genetically predisposed individuals. Ultrasound imaging of peripheral entheses reveals enthesis abnormalities including entheseal calcification, bony erosion, or bony proliferation. Power Doppler signals demonstrating increased vascularization of inflamed entheses at the insertional site appear to be the most characteristic finding for enthesitis, yet study results are conflicting. Enthesitis-related osteitis and enthesitis at the spine is best visualized by MRI. Enthesitis may resolve spontaneously or may run a chronic course. Standard treatment includes local steroid injections, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. There is little evidence for the efficacy of disease-modifying antirheumatic drugs (DMARDs) in enthesitis. In contrast, anti-TNF agents have proven efficacy, and their use in treatment-resistant enthesitis is recommended in the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of AS and axial SpA and in the EULAR recommendations for psoriatic arthritis.
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Coates, Laura C., Arthur Kavanaugh, and Christopher T. Ritchlin. Treatment algorithm and treat to target. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0032.
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This chapter covers the evidence for treatment algorithms and treatment to target in PsA. Evidence for treatment algorithms including step up vs step down approaches to prescribing and early vs delayed treatment is discussed. EULAR recommendations for treating to target in SpA are outlined with a summary of the level of evidence available at that time. Key outcome measures that could be utilized as targets in PsA are reviewed with discussion of their merits and deficiencies. A detailed description of the first treat to target study in PsA is presented: the TICOPA study. The impact of comorbidities on treatment decisions is discussed, both related SpA conditions such as uveitis and inflammatory bowel disease, and non-SpA comorbidities such as the metabolic syndrome and liver disease. Finally, suggestions for translation into clinical practice are outlined, highlighting the need for multi-speciality collaborative working, full assessment of disease activity and subsequent optimal treatment.
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van Assen, Sander, and Marc Bijl. Vaccination in immunocompromised adults. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0094.
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This chapter addresses all important questions regarding vaccination of patients with autoimmune inflammatory rheumatic diseases (AIIRD). First, the incidence of vaccine-preventable infections in these patients is discussed. Pulmonary infections, including influenza and pneumococcal infection, occur more often in AIIRD patients; herpes zoster and human papillomavirus are also more frequent. The efficacy of vaccination for all European registered vaccines is discussed. Treatment with disease-modifying anti-rheumatic drugs (DMARDs) and biologicals (in particular TNFα-blocking agents) do not hamper, or only slightly hamper, the immune responses to most vaccines. Rituximab is an exception, severely reducing humoral responses following influenza and pneumococcal vaccination, at least during the first 6 months after administration. Safety of vaccination is an important issue in patients with autoimmune diseases, since increased disease activity of the underlying disease as a result of vaccination is theoretically possible. The available evidence is summarized, suggesting that vaccination is safe in AIIRD patients. Live vaccines, however, are contraindicated in immunosuppressed patients with AIIRD. Finally, the European League Against Rheumatism (EULAR) recommendations are highlighted, summarizing the 'do's' and 'don'ts' of vaccination in adults with AIIRD.
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Heijstek, Marloes, Mario Abinun, and Nico Wulffraat. Vaccination in immunocompromised children. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0095.
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Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying anti-rheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. Although non-live vaccines are safe, it is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals. However, booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and anti-tumour necrosis factor alpha (TNFα) may lower vaccine-induced antibody concentrations. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.
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Heijstek, Marloes, Mario Abinun, and Nico Wulffraat. Vaccination in immunocompromised children. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0095_update_003.
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Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying antirheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. It is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals, but booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and tumour necrosis factor alpha (TNFα) may lower vaccine-induced antibody concentrations and may cause accelerated waning of immunity. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.
Book chapters on the topic "EULAR recommendation"
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Aga, Anna-Birgitte, Espen A. Haavardsholm, Till Uhlig, and Tore K. Kvien. "Clinical recommendations." In Oxford Textbook of Rheumatoid Arthritis. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198831433.003.0043.
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This chapter will review the most important recommendations that are relevant for evidence-based clinical practice. The main focus will be on recommendations that are specific to rheumatoid arthritis (RA) but some recommendation on special topics (e.g. biosimilars) will also be addressed. The literature to support evidence-based medicine is enormous, but the scientific quality may differ across studies. Recommendations based on systematic literature research may support evidence-based practice. Both the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) have published several important evidence-based recommendations. Further, task forces independent of these organizations have also presented important recommendations to support best practice. New treatment strategies have also improved RA care to an extent where remission has become an achievable goal for the majority of patients with RA. Important principles in the new treatment strategies are ‘window of opportunity’ which imply early initiation of disease-modifying antirheumatic drugs (DMARDs) before the onset of damage, and further ‘treat-to-target’ which is a strategy for follow-up with focus on reaching a predefined target, and where DMARD treatment is adjusted if the target is not achieved. Patients with early disease are monitored with ‘tight controls’, and with use of composite disease activity measures that includes joint counts.
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Rudwaleit, Martin. "Enthesitis." In Oxford Textbook of Rheumatology. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0054_update_003.
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Enthesitis is one of the key manifestations of spondyloarthritis (SpA) including ankylosing spondylitis (AS) and psoriatic arthritis. Enthesitis can occur alone or in combination with peripheral arthritis, sacroiliitis, or spondylitis. The inflammatory process is typically located at the insertion of the enthesis or ligament to bone, often resulting in osteitis as well. Because of its anatomical and functional complexity the term ’enthesis organ’ has been coined. Biomechanical stress applied to the enthesis seems to play an important role for the occurrence of enthesitis in genetically predisposed individuals. Ultrasound imaging of peripheral entheses reveals enthesis abnormalities including entheseal calcification, bony erosion, or bony proliferation. Power Doppler signals demonstrating increased vascularization of inflamed entheses at the insertional site appear to be the most characteristic finding for enthesitis, yet study results are conflicting. Enthesitis-related osteitis and enthesitis at the spine is best visualized by MRI. Enthesitis may resolve spontaneously or may run a chronic course. Standard treatment includes local steroid injections, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. There is little evidence for the efficacy of disease-modifying antirheumatic drugs (DMARDs) in enthesitis. In contrast, anti-TNF agents and other biologics have proven efficacy, and their use in treatment-resistant enthesitis is recommended in the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of AS and axial SpA and in the EULAR recommendations for psoriatic arthritis.
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Whatmore, Richard. "4. Political philosophers and the history of political thought." In The History of Political Thought: A Very Short Introduction. Oxford University Press, 2021. http://dx.doi.org/10.1093/actrade/9780198853725.003.0004.
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‘Political philosophers and the history of political thought’ discusses the confidence in the 1950s that the ‘right’ system of politics, economy and society had been discovered and linked with a turn away from history and theory. Behavioralism, which was propagated by Heinz Eulau, David Easton, and other political scientists, demanded the analysis of politics through the assertion of claims that could be verified or refuted. Data analysis could test hypotheses and come up with irrefutable policy recommendations. Domestic and international liberalism are coupled with variants of pacific socialism or communitarianism. There are a number of renowned political theorists who turned into public intellectuals, such as Norberto Bobbio and Jürgen Habermass.
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van Assen, Sander, and Marc Bijl. "Vaccination in immunocompromised adults." In Oxford Textbook of Rheumatology. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0094_update_001.
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This chapter addresses all important questions regarding vaccination of patients with autoimmune inflammatory rheumatic diseases (AIIRD). First, the incidence of vaccine-preventable infections in these patients is discussed. Pulmonary infections, including influenza and pneumococcal infection, occur more often in AIIRD patients; herpes zoster and human papillomavirus are also more frequent. The efficacy of vaccination for all European registered vaccines is discussed. Treatment with disease-modifying anti-rheumatic drugs (DMARDs) and biologicals (in particular TNFα-blocking agents) do not hamper, or only slightly hamper, the immune responses to most vaccines. Rituximab is an exception, severely reducing humoral responses following influenza and pneumococcal vaccination, at least during the first 6 months after administration. Safety of vaccination is an important issue in patients with autoimmune diseases, since increased disease activity of the underlying disease as a result of vaccination is theoretically possible. The available evidence is summarized, suggesting that vaccination is safe in AIIRD patients. Live vaccines, however, are contraindicated in immunosuppressed patients with AIIRD. Finally, the European League Against Rheumatism (EULAR) recommendations are highlighted, summarizing the ’do’s’ and ’don’ts’ of vaccination in adults with AIIRD.
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Caraba, Alexandru, Flavia Corina Babalic, Andreea Munteanu, and Otilia Tomulescu. "Cardiovascular Risk in Rheumatoid Arthritis." In Rheumatoid Arthritis. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.101259.
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Rheumatoid arthritis (RA), one of the most common inflammatory rheumatic diseases. It is defined as a chronic destructive and deforming arthropathy; it also finds its expression through systemic manifestations. RA has an undulating evolution, with remissions and relapses. Atherosclerotic cardiovascular disease represents one of the most common extra-articular manifestations of RA. It is known that the cardiovascular (CV) morbidity and mortality represent one of the leading causes of reduced life expectancy in RA. Patients with RA develop a premature and accelerated atherosclerosis, explaining the high incidence and prevalence of angina, myocardial infarction, congestive heart failure, stroke, peripheral artery disease, and the need for revascularization. Traditional risk factors (arterial hypertension, obesity, smoking, dyslipidemia, insulin resistance and metabolic syndrome, diabetes mellitus, male gender, physical inactivity) interplay with RA-related risk factors, generating endothelial dysfunction, arterial stiffness, carotid plaque, and atherosclerosis. Traditional cardiovascular risk factors alone cannot explain the increased incidence of premature and accelerated atherogenesis. Chronic inflammation, hyperhomocysteinemia, and hypercoagulation act as novel cardiovascular risk factors. Rheumatoid inflammation exerts direct effects on vessels, or by means of altered traditional risk factors. Antirheumatic drugs may promote atherogenesis or by reducing systemic inflammation may decrease cardiovascular risk. EULAR recommendations require annual cardiovascular risk assessment.
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Heijstek, Marloes, Mario Abinun, and Nico Wulffraat. "Vaccination in immunocompromised children." In Oxford Textbook of Rheumatology. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0095_update_004.
Full textAbstract:
Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying antirheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. It is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals, but booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and tumour necrosis factor alpha (TNFα) may lower vaccine-induced antibody concentrations and may cause accelerated waning of immunity. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.
Conference papers on the topic "EULAR recommendation"
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Mandl, P., E. De Lorenzis, F. G. Lazzaro, B. Wildner, and M. A. D’agostino. "POS0913 EVALUATION OF THE IMPLEMENTATION OF THE EULAR RECOMMENDATION CHECK LIST FOR TRANSPARENT AND COMPREHENSIVE REPORTING OF ULTRASOUND STUDIES IN RHEUMATIC AND MUSCULOSKELETAL DISEASES." In EULAR 2024 European Congress of Rheumatology, 12-15 June. Vienna, Austria. BMJ Publishing Group Ltd and European League Against Rheumatism, 2024. http://dx.doi.org/10.1136/annrheumdis-2024-eular.3989.
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Kleinmann, J.-F., L. Arnaud, E. Sauleau, N. Gouyette, R. Tajima, and J. Sibilia. "FRI0329 Efficacy and safety of infliximab originator in patients with takayasu arteritis within the RTU (temporary recommendation of use) in france." In Annual European Congress of Rheumatology, 14–17 June, 2017. BMJ Publishing Group Ltd and European League Against Rheumatism, 2017. http://dx.doi.org/10.1136/annrheumdis-2017-eular.1793.
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Ten Brinck, R. M., B. T. van Dijk, H. W. van Steenbergen, and A. H. van der Helm-van Mil. "FRI0633 How do we implement the eular recommendation that rheumatologists can see early arthritis patients within six weeks after symptom onset? a five-year comparative study of an early arthritis recognition clinic." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.4613.
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Slart, R. "FRI0589 A joint procedural recommendation on fdg-pet/ct(A) imaging in large vessel vasculitis and polymyalgia rheumatica from the cardiovascular and inflammation & infection committees of the eanm, the cardiovascular council of the snmmi, the pet interest group (PIG), and endorsed by the asnc." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.1181.
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d”Agostino, Maria-Antonietta. "SP0209 EULAR RECOMMENDATIONS FOR REPORTING IN MSK ULTRASOUND STUDIES." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.8455.
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Retamozo, S. "SP0159 Eular recommendations for the management of sjÖgren’s syndrome." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.7776.
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Fanouriakis, Antonis. "SP0189 UPDATE ON EULAR RECOMMENDATIONS FOR THE MANAGEMENT OF SLE." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.8473.
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Hellmich, Bernhard. "SP0192 UPDATE OF THE EULAR RECOMMENDATIONS LAGE VESSEL VASCULITIS MANAGEMENT." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.8496.
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Buttgereit, F. "SP0160 2018 eular recommendations for the use of glucocorticoid therapy." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.7690.
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Lems, W. F. "SP0135 The eular/efort recommendations for patients with recent fracture." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.7721.
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