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New EULAR recommendations for the intra-articular (IA) treatment of arthropathies aim to facilitate uniformity and quality of care forthis mainstay of rheumatologic practice,according to a report on the new guidancethat was presented at the congress.
Until now there were no official rec-
ommendations on how best to use it in
everyday practice. “This is the first time
that there’s been a joint effort to develop
evidence-based recommendations,” Dr.
Jacqueline Usón, associate professor
medicine at Rey Juan Carlos University in
Madrid, said in an interview. “Everything
that we are saying is pretty logical, but
IA therapy has been around for decades
and is key for treating adults with a number
of different conditions where synovitis,
Dr. Usón observed during her presentation.
“Today, commonly used injectables arenot only corticosteroids but also local anaesthetics, hyaluronic acid, blood products,and maybe pharmaceuticals,” she said,adding that “there is a wide variation inthe way intra-articular therapies are usedand delivered to patients.” Health professionals also have very different views andhabits depending on geographic locationsand healthcare systems, she observed.Ironing out the variation was one of themain objectives of the recommendations.
As one of the two conveners of the
EULAR task force behind the recommen-
dations, Dr. Usón, herself a rheumatologist
at University Hospital of Móstoles (Spain),
The task force followed EULAR stan-
dard operating procedures for developing
recommendations, with discussion groups,
systematic literature reviews, and Delphi
technique–based consensus all being em-
ployed. The literature search considered
publications from 1946 to 2019.
“We agreed on the need for morebackground information from health professionals and patients, so we developedtwo surveys: One for health professionalswith 160 items, [for which] we obtained186 responses from 26 countries; and thepatient survey was made up of 44 items,translated into 10 different languages, andwe obtained 200 responses,” she said.
The results of the systematic literaturereview and surveys were used to help formexpert consensus, leading to 5 overarchingprinciples and 11 recommendations that look
EULAR gives pointers on best practices
for intra-articular injection