Treat-to-target strategy for knee osteoarthritis. International technical expert panel consensus and good clinical practice statements.
NSAIDs
knee osteoarthritis
osteoarthritis
outcome research
treatment
Journal
Therapeutic advances in musculoskeletal disease
ISSN: 1759-720X
Titre abrégé: Ther Adv Musculoskelet Dis
Pays: England
ID NLM: 101517322
Informations de publication
Date de publication:
2019
2019
Historique:
received:
04
07
2019
accepted:
15
11
2019
entrez:
7
1
2020
pubmed:
7
1
2020
medline:
7
1
2020
Statut:
epublish
Résumé
In this work, we aimed to establish a clinical target in the management of knee osteoarthritis (KOA) and to propose good clinical practice (GCP) statements for carrying out a treat-to-target strategy. A steering committee of seven experts had formulated a provisional set of recommendations that were exposed for discussion and modification to a technical expert panel (TEP) of 25 multidisciplinary experts from Europe, North America, South America and Asia. The level of evidence and strength of each recommendation was discussed. The TEP formulated overarching principles and GCP statements based on the level of agreement for each item with a vote using a 10-point numerical scale. Two overarching principles and 10 GCP statements were formulated by the TEP. These GCP statements suggest: treatment should achieve clinical improvement bringing the patient to the Patient Acceptable Symptom State (PASS); pharmacological and nonpharmacological treatment should begin as early as possible, with an early diagnosis of symptomatic KOA; the patient should be evaluated every 3-6 months; risk factors of KOA progression should be identified and managed with patients at the beginning of the treatment and monitored regularly; treatment should be adapted according to patient phenotype and disease severity; healthy lifestyle must be promoted and monitored. The level of agreement average ranged from 8.7 to 9.6 on scale. The proposed overarching principles and GCP statements have the aim of involving patients, general practitioners and multidisciplinary specialists in sharing a therapeutic treat-to-target strategy for KOA management based on the best evidence and expert opinions.
Sections du résumé
BACKGROUND
BACKGROUND
In this work, we aimed to establish a clinical target in the management of knee osteoarthritis (KOA) and to propose good clinical practice (GCP) statements for carrying out a treat-to-target strategy.
METHODS
METHODS
A steering committee of seven experts had formulated a provisional set of recommendations that were exposed for discussion and modification to a technical expert panel (TEP) of 25 multidisciplinary experts from Europe, North America, South America and Asia. The level of evidence and strength of each recommendation was discussed. The TEP formulated overarching principles and GCP statements based on the level of agreement for each item with a vote using a 10-point numerical scale.
RESULTS
RESULTS
Two overarching principles and 10 GCP statements were formulated by the TEP. These GCP statements suggest: treatment should achieve clinical improvement bringing the patient to the Patient Acceptable Symptom State (PASS); pharmacological and nonpharmacological treatment should begin as early as possible, with an early diagnosis of symptomatic KOA; the patient should be evaluated every 3-6 months; risk factors of KOA progression should be identified and managed with patients at the beginning of the treatment and monitored regularly; treatment should be adapted according to patient phenotype and disease severity; healthy lifestyle must be promoted and monitored. The level of agreement average ranged from 8.7 to 9.6 on scale.
CONCLUSIONS
CONCLUSIONS
The proposed overarching principles and GCP statements have the aim of involving patients, general practitioners and multidisciplinary specialists in sharing a therapeutic treat-to-target strategy for KOA management based on the best evidence and expert opinions.
Identifiants
pubmed: 31903099
doi: 10.1177/1759720X19893800
pii: 10.1177_1759720X19893800
pmc: PMC6923692
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1759720X19893800Informations de copyright
© The Author(s), 2019.
Déclaration de conflit d'intérêts
Conflict of interest statement: Abiogen Pharma Spa supported all the costs of the meeting of the authors, including travel and subsistence. No honoraria were paid to the participants. Abiogen Pharma Spa had no input in the writing or editing of the paper.
Références
Maturitas. 2016 Jul;89:22-8
pubmed: 27180156
Rheumatology (Oxford). 2014 Jan;53(1):1-3
pubmed: 23878311
CMAJ. 2018 Jan 22;190(3):E72-E79
pubmed: 29358201
Postgrad Med. 2009 Nov;121(6):9-20
pubmed: 19940413
BMJ. 2011 Jan 11;342:c7086
pubmed: 21224324
J Am Coll Cardiol. 2018 Apr 24;71(16):1741-1751
pubmed: 29673465
Ann Rheum Dis. 2016 Jan;75(1):3-15
pubmed: 25969430
Ann Intern Med. 1988 Jul 1;109(1):18-24
pubmed: 3377350
Osteoarthritis Cartilage. 2014 Mar;22(3):363-88
pubmed: 24462672
J Diabetes Complications. 2016 Jul;30(5):944-50
pubmed: 27114387
Eur J Prev Cardiol. 2016 Jun;23(9):938-46
pubmed: 26464295
Osteoarthritis Cartilage. 2010 Apr;18(4):476-99
pubmed: 20170770
Semin Arthritis Rheum. 2016 Feb;45(4 Suppl):S22-7
pubmed: 26806184
Med Health R I. 2004 Jul;87(7):201-4
pubmed: 15354794
Hypertension. 2015 Sep;66(3):524-33
pubmed: 26169048
Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589
pubmed: 31278997
Knee. 2007 Dec;14(6):417-23
pubmed: 17596949
Ann Rheum Dis. 2011 Sep;70(9):1534-41
pubmed: 21804100
Osteoarthritis Cartilage. 2017 Dec;25(12):1926-1941
pubmed: 28847624
Drugs Aging. 2015 Mar;32(3):179-87
pubmed: 25701074
Diabetes Res Clin Pract. 2016 Dec;122:198-206
pubmed: 27889689
Rheumatol Int. 2017 Aug;37(8):1227-1236
pubmed: 28451793
N Engl J Med. 2016 Dec 29;375(26):2519-29
pubmed: 27959716
Ann Rheum Dis. 2005 Jan;64(1):34-7
pubmed: 15130902
Osteoarthritis Cartilage. 2015 May;23(5):747-60
pubmed: 25952346
Ann Rheum Dis. 2016 Oct;75(10):1749-56
pubmed: 26543059
Osteoarthritis Cartilage. 2015 Apr;23(4):544-9
pubmed: 25596322
Eur Rev Med Pharmacol Sci. 2015 Apr;19(7):1124-9
pubmed: 25912569
Osteoarthritis Cartilage. 2012 Nov;20(11):1217-26
pubmed: 22796312
Arthritis Res Ther. 2007;9(1):R11
pubmed: 17266764
Joint Bone Spine. 2014 Jan;81(1):4-5
pubmed: 24387971
Semin Arthritis Rheum. 2009 Oct;39(2):71-80
pubmed: 19589561
Mil Med. 2014 Aug;179(8):815-20
pubmed: 25102523
Osteoarthritis Cartilage. 2015 Apr;23(4):550-8
pubmed: 25576879
Arthritis Rheum. 2000 May;43(5):995-1000
pubmed: 10817551
BMJ. 2011 Mar 08;342:d1165
pubmed: 21385807
Ann Rheum Dis. 2009 Apr;68(4):490-6
pubmed: 18467514
Arthritis Care Res (Hoboken). 2012 Apr;64(4):465-74
pubmed: 22563589
Br J Sports Med. 2018 May;52(10):642-650
pubmed: 29436380
Obesity (Silver Spring). 2008 Feb;16(2):232-40
pubmed: 18239629
Knee. 2012 Aug;19(4):316-9
pubmed: 21782451
Arthritis Care Res (Hoboken). 2012 Nov;64(11):1699-707
pubmed: 22674853
Semin Arthritis Rheum. 2019 Feb;48(4):563-572
pubmed: 30072113
Ann Rheum Dis. 2013 Jul;72(7):1125-35
pubmed: 23595142
J Am Acad Orthop Surg. 2013 Sep;21(9):571-6
pubmed: 23996988
Osteoarthritis Cartilage. 2014 May;22(5):622-30
pubmed: 24662734
RMD Open. 2017 Aug 29;3(2):e000442
pubmed: 29435358
Ann Rheum Dis. 2011 Jan;70(1):139-44
pubmed: 20980288
BMC Nephrol. 2017 Aug 1;18(1):256
pubmed: 28764659
Ann Transl Med. 2016 Apr;4(7):133
pubmed: 27162783
Ann Rheum Dis. 2016 Mar;75(3):552-9
pubmed: 25732175
Medicine (Baltimore). 2016 May;95(20):e3739
pubmed: 27196498
Ann Rheum Dis. 2018 Sep;77(9):1251-1260
pubmed: 29997112
Osteoarthritis Cartilage. 2012 Jun;20(6):495-502
pubmed: 22401872
BMC Musculoskelet Disord. 2016 Oct 12;17(1):425
pubmed: 27733199
Pharmacoepidemiol Drug Saf. 2018 Jan;27(1):69-77
pubmed: 29171096
Ann Rheum Dis. 2010 Apr;69(4):631-7
pubmed: 20215140
Expert Opin Drug Saf. 2017 Aug;16(8):897-902
pubmed: 28627937
Lancet. 2013 Aug 31;382(9894):769-79
pubmed: 23726390
J Rheumatol. 2018 Jan;45(1):122-127
pubmed: 28811352
Ann Phys Rehabil Med. 2016 Jun;59(3):157-160
pubmed: 27211819
Osteoarthritis Cartilage. 2009 Dec;17(12):1562-9
pubmed: 19583959
Open Orthop J. 2018 Mar 16;12:105-114
pubmed: 29619124
Br J Gen Pract. 2016 Jan;66(642):e32-9
pubmed: 26639946
Phys Ther. 2010 Mar;90(3):356-66
pubmed: 20056719
Cochrane Database Syst Rev. 2015 Jan 09;1:CD004376
pubmed: 25569281
Bull World Health Organ. 2003;81(9):646-56
pubmed: 14710506
Expert Opin Pharmacother. 2016 Sep;17(13):1745-56
pubmed: 27326466
RMD Open. 2015 Jun 02;1(1):e000077
pubmed: 26535137
JAMA. 2013 Sep 25;310(12):1263-73
pubmed: 24065013
Semin Arthritis Rheum. 2019 Dec;49(3):337-350
pubmed: 31126594
J Sci Med Sport. 2011 Jan;14(1):4-9
pubmed: 20851051
BMJ. 2017 May 10;357:j1982
pubmed: 28490431
Cartilage. 2018 Jul;9(3):263-275
pubmed: 29110511
Cartilage. 2018 Oct;9(4):370-377
pubmed: 28800711
Open Rheumatol J. 2014 Nov 28;8:89-95
pubmed: 25489352
Am J Clin Nutr. 2017 Sep;106(3):755-763
pubmed: 28747328
J Orthop Res. 2018 Mar;36(3):876-880
pubmed: 28776751
Ann Rheum Dis. 2007 Apr;66(4):433-9
pubmed: 17204567
J Am Acad Orthop Surg. 2013 Sep;21(9):577-9
pubmed: 23996989
Ann Rheum Dis. 2014 Jul;73(7):1323-30
pubmed: 24553908
Drugs Aging. 2018 Jun;35(6):559-568
pubmed: 29737468
BMC Musculoskelet Disord. 2008 Oct 02;9:132
pubmed: 18831740