Cited by 1,338Osteoarthritis Treatment and MechanismsOrthopedic Surgery and RehabilitationMusculoskeletal pain and rehabilitation

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EULAR evidence based recommendations for the management of hand osteoarthritis: Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)

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Zhang, W, Doherty, M, Leeb, B F, Alekseeva, L, Arden, N K, Bijlsma, J W, Dinçer, F, Dziedzic, K, Häuselmann, H J, Herrero-Beaumont, G, Kaklamanis, P, Lohmander, S, Maheu, E, Martín-Mola, E, Pavelka, K, Punzi, L, Reiter, S, Sautner, J, Smolen, J, Verbruggen, G, Zimmermann-Górska, I·2007·Annals of the Rheumatic Diseases

DOI 10.1136/ard.2006.062091PMC PMC1856004

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Abstract

Objectives To develop evidence based recommendations for the management of hand osteoarthritis (OA). Methods The multidisciplinary guideline development group comprised 16 rheumatologists, one physiatrist, one orthopaedic surgeon, two allied health professionals, and one evidence based medicine expert, representing 15 different European countries. Each participant contributed up to 10 propositions describing key clinical points for management of hand OA. Final recommendations were agreed using a Delphi consensus approach. A systematic search of Medline, Embase, CINAHL, Science Citation Index, AMED, Cochrane Library, HTA, and NICE reports was used to identify the best available research evidence to support each proposition. Where possible, the effect size and number needed to treat were calculated for efficacy. Relative risk or odds ratio was estimated for safety, and incremental cost effectiveness ratio was used for cost effectiveness. The strength of recommendation was provided according to research evidence, clinical expertise, and perceived patient preference. Results Eleven key propositions involving 17 treatment modalities were generated through three Delphi rounds. Treatment topics included general considerations (for example, clinical features, risk factors, comorbidities), non-pharmacological (for example, education plus exercise, local heat, and splint), pharmacological (for example, paracetamol, NSAIDs, NSAIDs plus gastroprotective agents, COX-2 inhibitors, systemic slow acting disease modifying drugs, intra-articular corticosteroids), and surgery. Of 17 treatment modalities, only six were supported by research evidence (education plus exercise, NSAIDs, COX-2 inhibitors, topical NSAIDs, topical capsaicin, and chondroitin sulphate). Others were supported either by evidence extrapolated from studies of OA affecting other joint sites or by expert opinion. Strength of recommendation varied according to level of evidence, benefits and harms/costs of the treatment, and clinical expertise. Conclusion Eleven key recommendations for treatment of hand OA were developed using a combination of research based evidence and expert consensus. The evidence was evaluated and the strength of recommendation was provided.

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Sorted by citations

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See all 1,338

Authors: Zhang, W., Doherty, M., Leeb, B. F., Alekseeva, L., Arden, N. K., Bijlsma, J. W., Dinçer, F., Dziedzic, K., Häuselmann, H. J., Herrero-Beaumont, G., Kaklamanis, P., Lohmander, S., Maheu, E., Martín-Mola, E., Pavelka, K., Punzi, L., Reiter, S., Sautner, J., Smolen, J., Verbruggen, G., & Zimmermann-Górska, I.
Affiliations: University of Nottingham (GB)
Southampton General Hospital (GB)
University Medical Center Utrecht (NL)
Hacettepe University (TR)
Keele University (GB)
Hirslanden Klinik Im Park (CH)
Lund University (SE)
Hôpital Saint-Antoine (FR)
Hospital Universitario La Paz (ES)
University of Padua (IT)
Federal Institute for Drugs and Medical Devices (DE)
Ghent University Hospital (BE)
Corresponding author: Zhang, W
ORCID: Zhang, W
Doherty, M
Leeb, B F
Arden, N K
Bijlsma, J W
Dinçer, F
Dziedzic, K
Lohmander, S
Maheu, E
Punzi, L
Sautner, J
Smolen, J
Verbruggen, G
Venue: Annals of the Rheumatic Diseases
Publisher: Elsevier BV
Published: 2007-03
Volume: 66
Issue: 3
Pages: 377-388
ISSN: 0003-4967 (ISSN-L)
DOI: 10.1136/ard.2006.062091
PMC: PMC1856004
OpenAlex: W2113737049
Cited by: 1,338
References: 271
Citations by year: 2026: 7 · 2025: 12 · 2024: 8 · 2023: 21 · 2022: 18 · 2021: 41 · 2020: 52 · 2019: 50 · 2018: 65 · 2017: 61 · 2016: 64 · 2015: 67 · 2014: 108 · 2013: 121 · 2012: 94
FWCI: 58.07
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Annals of the Rheumatic Diseases (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion)
ePrints Soton (University of Southampton) (submittedVersion)
Lund University Publications (Lund University) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
Padua Research Archive (University of Padova) (submittedVersion)
Funders: European League Against Rheumatism
U.S. Food and Drug Administration
Topics: Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords: hand osteoarthritis, treatment guidelines, non-pharmacological treatment, splinting, nonsteroidal anti-inflammatory drugs, COX-2 inhibitors, topical NSAIDs, topical capsaicin, chondroitin sulfate, intra-articular corticosteroids, paracetamol, cost-effectiveness, strength of recommendation
MeSH terms: Anti-Inflammatory Agents, Non-Steroidal, Delphi Technique, Glucocorticoids, Hot Temperature, Humans, Injections, Intra-Articular, Osteoarthritis, Patient Education as Topic, Review Literature as Topic, Outcome Assessment, Health Care, Evidence-Based Medicine, Hand Joints

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EULAR evidence based recommendations for the management of hand osteoarthritis: Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)

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