title: The importance of assessment and management of morning stiffness in Asian patients with rheumatoid arthritis: Recommendations from an expert panel.
abstract: OBJECTIVE
  In patients with rheumatoid arthritis (RA), morning stiffness is linked more to functional disability and pain than disease activity, as assessed by joint counts and markers of inflammation. As part of the Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel, a group of eight rheumatologists met to formulate consensus points and develop recommendations for the assessment and management of morning stiffness in RA.
  
  
  METHODS
  On the basis of a systematic literature review and expert opinion, a panel of Asian rheumatologists formulated recommendations for the assessment and medical treatment of RA.
  
  
  RESULTS
  The panel agreed upon 10 consensus statements on morning stiffness, its assessment and treatment. Specifically, the panel recommended that morning stiffness, pain and impaired morning function should be routinely assessed in clinical practice. Although there are currently no validated tools for these parameters, they should be assessed as part of the patients' reported outcomes in RA. The panel also agreed on the benefits of low-dose glucocorticoids in RA, particularly for the improvement of morning stiffness.
  
  
  CONCLUSIONS
  These recommendations serve to guide rheumatologists and other stakeholders on the assessment and management of morning stiffness, and help implement the treat-to-target principle in the management of RA.
authors.affiliation: Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: Chi Chiu
authors.initials: CC
authors.lastname: Mok
authors.affiliation: Sungkyunkwan University, Seoul, South Korea.
authors.forename: Hoon Suk
authors.initials: HS
authors.lastname: Cha
authors.affiliation: Dr Ciptomangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Rudy
authors.initials: R
authors.lastname: Hidayat
authors.affiliation: Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Lan Thi Ngoc
authors.initials: LT
authors.lastname: Nguyen
authors.affiliation: De la Salle University Medical Center, Health Science Institute, Cavite, Philippines.
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Perez
authors.affiliation: Sime Darby Medical Centre, Subang Jaya, Malaysia.
authors.forename: Raveendran
authors.initials: R
authors.lastname: Ramachandran
authors.affiliation: Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Tsay
authors.affiliation: Hanyang University, Seoul, South Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Yoo
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage*; D018771:Arthralgia / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D002940:Circadian Rhythm; D032921:Consensus; D004185:Disability Evaluation; D055870:Drug Chronotherapy; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007596:Joints / Q000187:drug effects* / Q000503:physiopathology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011788:Quality of Life; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids
keywords: consensus recommendations; morning stiffness; rheumatoid arthritis