The 2018 update of recommendations for the management of hand osteoarthritis (OA) from the European League Against Rheumatism (EULAR) incorporate new evidence developed during the last decade, emphasizing the role of the patient in the OA treatment plan and the importance of multimodal/multidisciplinary therapy.
Margreet Kloppenburg, MD, PhD, from the Department of Rheumatology and the Department of Clinical Epidemiology; Féline P.B. Kroon, MD, PhD student, from the Department of Rheumatology, all at Leiden University, the Netherlands, and colleagues published their findings online August 28 in the Annals of the Rheumatic Diseases.
The recommendations add a new emphasis on optimizing and maximizing symptom control (rather than « joint protection ») and modify previous guidance on patient education and treatment individualization.
EULAR recommends topical nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line pharmacologic treatment for hand OA. This differs from previous EULAR guidance and from the 2012 American College of Rheumatology recommendations. EULAR also recommends education about ergonomic principles, activity pacing, use of assistive devices, and exercises to improve function and muscle strength as the initial steps in managing hand OA, with or without topical NSAIDs…