title: 2016 update of the EULAR recommendations for the management of early arthritis.
abstract: OBJECTIVE
  Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis.
  
  
  METHODS
  In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process.
  
  
  RESULTS
  The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research.
  
  
  CONCLUSIONS
  These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis.
authors.affiliation: Rheumatology Department, Lapeyronie Hospital, Montpellier University, UMR 5535, Montpellier, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.affiliation: Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam and Zuyderland Medical Centre, Heerlen, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Landewe
authors.affiliation: Rheumatology Department, Lapeyronie Hospital, Montpellier University, UMR 5535, Montpellier, France.
authors.forename: Claire I
authors.initials: CI
authors.lastname: Daien
authors.affiliation: Rheumatology Department, Lapeyronie Hospital, Montpellier University, UMR 5535, Montpellier, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hua
authors.affiliation: Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Aletaha
authors.affiliation: Biological Therapies Unit, Servicio de Reumatología. Hospital Universitario de la Princesa, IIS-IP, Madrid, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Álvaro-Gracia
authors.affiliation: EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
authors.forename: Margôt
authors.initials: M
authors.lastname: Bakkers
authors.affiliation: Division of Physiotherapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.|Department of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
authors.forename: Nina
authors.initials: N
authors.lastname: Brodin
authors.affiliation: Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany.
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Burmester
authors.affiliation: Department of Rheumatology, Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Catalin
authors.initials: C
authors.lastname: Codreanu
authors.affiliation: Department of Rheumatology, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin Academic Medical Centre, Dublin, Ireland.
authors.forename: Richard
authors.initials: R
authors.lastname: Conway
authors.affiliation: Medicine Faculty, APHP, Rheumatology B Department, Paris Descartes University, Cochin Hospital, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Leeds NIHR Musculoskeletal Biomedical Research Unit, LTHT, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
authors.affiliation: Fondazione Policlinico Gemelli Academic Hospital, Catholic University School of Medicine, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferraccioli
authors.affiliation: Rheumatology Department, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon.|Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa, Portugal.
authors.forename: Joao
authors.initials: J
authors.lastname: Fonseca
authors.affiliation: Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.|Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
authors.forename: Karim
authors.initials: K
authors.lastname: Raza
authors.affiliation: Rheumatology Department, Complexo Hospitalario Universitario de Ferrol, A Coruña, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Silva-Fernández
authors.affiliation: Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
authors.forename: Josef S
authors.identifier: http://orcid.org/0000-0002-8899-9087
authors.initials: JS
authors.lastname: Smolen
authors.affiliation: EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
authors.forename: Diana
authors.initials: D
authors.lastname: Skingle
authors.affiliation: Faculty of Medicine, Department of Rheumatology, University of Debrecen, Debrecen, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Szekanecz
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.|Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Annette
authors.initials: A
authors.lastname: van der Helm-van Mil
authors.affiliation: Department of Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: van Vollenhoven
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000175:diagnosis* / Q000188:drug therapy* / Q000628:therapy; D005081:Exercise Therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008019:Life Style; D009788:Occupational Therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D005938:Glucocorticoids
keywords: DMARDs (synthetic); Early Rheumatoid Arthritis; Patient perspective; Rheumatoid Arthritis; Treatment