Management of Rheumatoid Arthritis: Consensus Recommendations From the Turkish League Against Rheumatism
Şebnem ATAMAN, 1 Pınar BORMAN, 2 Deniz EVCİK, 3 Ece AYDOĞ, 4 Figen AYHAN, 2 Derya YILDIZLAR, 5 Hatice BODUR, 6 Zuhal ALTAY, 7 Murat BİRTANE, 8 Bülent BÜTÜN, 9 Tuncay DURUÖZ, 10 Hatice Rana ERDEM, 2 Zafer GÜNENDİ, 11 Rezzan GÜNAYDIN, 12 Gülcan GÜRER, 13 Cahit KAÇAR, 9 Ece KAPTANOĞLU, 14 Taciser KAYA, 12 Neşe ÖLMEZ, 15 Nurdan PAKER, 16 Aylin REZVANİ, 17 Birkan SONEL TUR, 5 Mahmut YENER, 18 Salih ÖZGÖÇMEN19
1Department of Physical Medicine and Rehabilitation, Medical Faculty of Ankara University, Division of Rheumatology, Ankara, Turkey
2Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
3Department of Therapy and Rehabilitation, Ankara University, Haymana Vocational School, Ankara, Turkey
4Department of Physical Medicine and Rehabilitation, Medical Faculty of Yeditepe University, İstanbul, Turkey
5Department of Physical Medicine and Rehabilitation, Medical Faculty of Ankara University, Ankara, Turkey
6Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey
7Department of Physical Medicine and Rehabilitation, Medical Faculty of İnönü University, Malatya, Turkey
8Department of Physical Medicine and Rehabilitation, Medical Faculty of Trakya University, Edirne, Turkey
9Department of Physical Medicine and Rehabilitation, Medical Faculty of Akdeniz University, Division of Rheumatology, Antalya, Turkey
10Department of Physical Medicine and Rehabilitation, Medical Faculty of Celal Bayar University, Division of Rheumatology, Manisa, Turkey
11Department of Physical Medicine and Rehabilitation, Medical Faculty of Gazi University, Division of Rheumatology, Ankara, Turkey
12Department of Physical Medicine and Rehabilitation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
13Department of Physical Medicine and Rehabilitation, Van Training and Research Hospital, Division of Rheumatology, Van, Turkey
14Department of Physical Medicine and Rehabilitation, Medical Faculty of Cumhuriyet University, Division of Rheumatology, Sivas, Turkey
15Department of Physical Medicine and Rehabilitation, İzmir Atatürk Training and Research Hospital, İzmir, Turkey
16İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbul, Turkey
17Department of Physical Medicine and Rehabilitation, Medical Faculty of Bezmialem Vakıf University, İstanbul, Turkey
18Department of Physical Medicine and Rehabilitation, Medical Faculty of Süleyman Demirel University, Isparta, Turkey
19Department of Physical Medicine and Rehabilitation, Medical Faculty of Erciyes University, Division of Rheumatology, Kayseri, Turkey
Keywords: Guidelines; rheumatoid arthritis; treatment
Abstract
Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions.
Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope “Recommendations for the Management of RA in Turkey” based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated.
Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon.
Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated.