The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of knee, hip and hand osteoarthritis
A. Ariani,
M. Manara,
A. Fioravanti,
F. Iannone,
F. Salaffi,
N. Ughi,
I. Prevete,
A. Bortoluzzi,
S. Parisi,
C.A. Scirè
Affiliations
A. Ariani
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Department of Medicine, Internal Medicine and Rheumatology Unit, University Hospital of Parma
M. Manara
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Clinic, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini-CTO ASST Gaetano Pini, Milan
A. Fioravanti
Rheumatology Unit-Azienda Ospedaliera Universitaria Senese, Siena
F. Iannone
Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari
F. Salaffi
Rheumatology Clinic, Ospedale Carlo Urbani, Università Politecnica delle Marche, Jesi (AN)
N. Ughi
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Clinic, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini-CTO ASST Gaetano Pini, Milan
I. Prevete
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome
A. Bortoluzzi
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Section, Department of Medical Sciences, University of Ferrara
S. Parisi
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Unit, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin
C.A. Scirè
Epidemiology Research Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Section, Department of Medical Sciences, University of Ferrara
Osteoarthritis (OA) is the most common musculoskeletal disease leading to functional decline and loss in quality of life. Knees, hands and hips are frequently affected joints with a relevant clinical and socio-economic burden. An evidence-based approach to OA management is essential in order to improve patients’ health and to decrease social burdens. Since new international clinical practice guidelines (CPGs) focused on diagnosis or pharmacological/non-pharmacological treatment have become available in the last ten years, the Italian Society for Rheumatology (SIR) was prompted to revise and customize them for a multidisciplinary audience of specialists involved in the management of OA. The framework of the Guidelines International Network Adaptation Working Group was adopted to identify, appraise (AGREE II), synthesize, and customize the existing CPGs on OA to the needs of the Italian healthcare context. The task force, consisting of rheumatologists from the SIR epidemiology research unit and a committee with experience of OA, identified key health questions to guide a systematic review of published guidelines. The target audience included physicians and health professionals who manage OA. An external panel of stakeholders rated the guidelines. From a systematic search in databases (Pubmed/Medline, Embase) and grey literature, 11 CPGs were selected and appraised by two independent raters. Combining evidence and statements from these CPGs and clinical expertise, 16 guidelines were developed and graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. These revised guidelines are intended to provide guidance for diagnosis and treatment of OA and to disseminate best evidence-based strategies management of the disease.
