The Italian Society for Rheumatology clinical practice guidelines for rheumatoid arthritis

  • S. Parisi | simone.parisi@hotmail.it Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Rheumatology Unit, University Hospital, Turin, Italy.
  • A. Bortoluzzi Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medical Sciences, Rheumatology Section, University of Ferrara, Italy.
  • G.D. Sebastiani Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
  • F. Conti Rheumatology Division, I Clinica Medica, Policlinico Umberto I, Rome, Italy.
  • R. Caporali Department of Rheumatology, University and IRCCS Foundation Policlinico S. Matteo, Pavia, Italy.
  • N. Ughi Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Division of Clinical Rheumatology, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini CTO ASST, Milan, Italy.
  • I. Prevete Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
  • A. Ariani Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Italy.
  • M. Manara Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Division of Clinical Rheumatology, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini CTO ASST, Milan, Italy.
  • G. Carrara Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy.
  • C.A. Scirè Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medical Sciences, Rheumatology Section, University of Ferrara, Italy.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder characterised by chronic joint inflammation, leading to functional disability and increased risk of premature death. Clinical practice guidelines (CPGs) are expected to play a key role in improving management of RA, across the different phases of the disease course. Since new evidence has become available, the Italian Society for Rheumatology (SIR) has been prompted to update the 2011 recommendations on management of RA. The framework of the Guidelines International Network Adaptation Working Group was adopted to identify, appraise (AGREE II), synthesize, and customize the existing RA CPGs to the Italian healthcare context. The task force consisting of rheumatologists from the SIR Epidemiology Research Unit and a committee with experience in RA identified key health questions to guide a systematic literature review. The target audience includes physicians and health professionals who manage RA in practice, and the target population includes adult patients diagnosed as having RA. An external multi-disciplinary committee rated the final version of the CPGs. From the systematic search in databases (Medline, Embase) and grey literature, 6 CPGs were selected and appraised by two independent raters. Combining evidence and statements from these CPGs and clinical expertise, 8 (Management) +6 (Safety) recommendations were developed and graded according to the level of evidence. The statements and potential impact on clinical practice were discussed and assessed. These revised recommendations are intended to provide guidance for the management of RA and to disseminate the best evidence-based clinical practices for this disease.

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Published
2019-09-23
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Issue
Section
Reviews
Keywords:
Clinical practice guidelines, recommendations, rheumatoid arthritis, management, safety.
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How to Cite
Parisi, S., Bortoluzzi, A., Sebastiani, G., Conti, F., Caporali, R., Ughi, N., Prevete, I., Ariani, A., Manara, M., Carrara, G., & Scirè, C. (2019). The Italian Society for Rheumatology clinical practice guidelines for rheumatoid arthritis. Reumatismo, 71(S1), 22-49. https://doi.org/10.4081/reumatismo.2019.1202