Pharmacological treatment (biotherapy excluded) of peripheral psoriatic arthritis: development of recommendations for clinical practice based on data from the literature and experts opinion.
OBJECTIVE
To develop recommendations about treatment (except anti-TNF agents) of psoriatic arthritis with peripheral joint involvement (PsA) seen in everyday practice, using evidence from the literature, supplemented with expert opinion when needed.


METHODS
The recommendations were based on evidence from the literature. First, a scientific committee used a Delphi procedure to select five focal points of interest. Then, a literature task force looked for relevant publications in the following: Cochrane, Pubmed, and Ovid databases and abstracts from the French Society for Rheumatology, European League against Rheumatism and American College of Rheumatology. Based on the data from these publications, recommendations were drafted and then validated by a group of 68 experts. The strength of each recommendation was determined, as well as the extent of agreement among the experts.


RESULTS
The evidence extracted from 73 selected papers was presented to experts during interactive workshops. At the end of the workshops, the experts drafted six recommendations, which were then validated by a final vote including all participants. These six recommendations displayed various strength from B to D.


CONCLUSIONS
These recommendations should help to improve practice uniformity and, ultimately, to improve the management of PsA in France.
Dernis
Emmanuelle
E
Service de Rhumatologie, Centre Hospitalier, Le Mans, France.
Lavie
Frédéric
F
Salliot
Carine
C
Flipo
René-Marc
RM
Saraux
Alain
A
Maillefert
Jean-Francis
JF
Paul
Carle
C
Goupille
Philippe
P
Cantagrel
Alain
A
Claudepierre
Pascal
P
Gaudin
Philippe
P
Tebib
Jacques
J
Wendling
Daniel
D
Schaeverbeke
Thierry
T
Le Loët
Xavier
X
Combe
Bernard
B
D026683:Advisory Committees; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D001379:Azathioprine / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006784:Hospitals, Teaching; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use; D007596:Joints / Q000473:pathology; D000077339:Leflunomide; D010919:Placebos; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007555:Isoxazoles; D010919:Placebos; D000077339:Leflunomide; D001379:Azathioprine