Nonpharmacological treatments in early rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion. - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Joint Bone Spine Année : 2006

Nonpharmacological treatments in early rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion.

Stephan Pavy
  • Fonction : Auteur
Arnaud Constantin
  • Fonction : Auteur
  • PersonId : 1119779
Xavier Mariette
Thierry Schaeverbeke
Alain Cantagrel
  • Fonction : Auteur
  • PersonId : 918914

Résumé

OBJECTIVE: To develop clinical practice guidelines for the use of nonpharmacological treatments in patients with early rheumatoid arthritis (RA), using the evidence-based approach and expert opinion. METHODS: A scientific committee used a Delphi prioritization procedure to select five questions. Evidence providing answers to the five questions was sought in the literature and presented to a panel of rheumatologists. The panel developed five detailed recommendations, filling gaps in evidence with their expert opinion. The strength of each recommendation was determined. RESULTS: Of the 565 publications retrieved by the literature review, 198 were included in the analysis. The five recommendations on nonpharmacological treatments for early RA were validated by a final vote among all participants. The recommendations are as follows: (1) physicians may decide to provide joint protection education to patients with potentially severe early RA, with the knowledge that structured joint protection programs have not been found effective; (2) physical exercise and sports can be recommended to patients with early RA; muscle strength exercises are advisable; (3) in patients with early RA, metatarsal pain and/or foot alignment abnormalities should be looked for regularly, and appropriate insoles should be prescribed if needed; (4) dietary measures and nutritional supplements are not indicated as part of the treatment of early RA; (5) elimination diets, particularly those with low intakes of dairy products, should be discouraged in patients with early RA. CONCLUSION: These recommendations should help to improve practice uniformity and, ultimately, to improve the management of RA.

Dates et versions

hal-00465301 , version 1 (19-03-2010)

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Citer

Laure Gossec, Stephan Pavy, Thao Pham, Arnaud Constantin, Serge Poiraudeau, et al.. Nonpharmacological treatments in early rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion.. Joint Bone Spine, 2006, 73 (4), pp.396-402. ⟨10.1016/j.jbspin.2006.01.008⟩. ⟨hal-00465301⟩
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