2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative
2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative
复制标题
DOI：
10.1136/annrheumdis-2015-207492
复制
发表时间：
2015-10-01
影响因子：
27.4
通讯作者：
Dasgupta, Bhaskar
中科院分区：
文献类型：
--
作者：
Dejaco, Christian;Singh, Yogesh P.;Dasgupta, Bhaskar
风湿性多肌痛（PMR）的治疗在临床实践中差异很大，因为目前尚无PMR治疗的国际建议。在本文中，我们报告了2015年欧洲抗风湿病联盟（EULAR）/美国风湿病学院（ACR）关于PMR管理的建议。我们使用建议、评估、发展和评价的分级（GRADE）方法作为该项目的框架。因此，建议的方向和力度是基于证据的质量，理想和不理想的效果之间的平衡，患者和临床医生的价值观和偏好，以及资源使用。制定了八项总体原则和九项具体建议，涵盖PMR的几个方面，包括接受治疗的患者的基本和随访调查、风险因素评估、患者的医疗访问和专家转诊、治疗策略（如初始糖皮质激素（GC）剂量和随后的减量方案）、肌内GC和疾病缓解抗风湿药物（DMARD）的使用，以及非甾体类抗风湿药物和非药物干预的作用。这些建议将告知初级，二级和三级保健医生关于PMR管理的国际共识。这些建议应有助于告知临床医生有关PMR患者护理的最佳实践。
Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR.