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Title: EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases
Authors: Duru, N ×
van der Goes, M C
Jacobs, J W G
Andrews, Tara
Boers, M
Buttgereit, F
Caeyers, N
Cutolo, M
Halliday, S
Da Silva, J A P
Kirwan, J R
Ray, D
Rovensky, J
Severijns, G
Westhovens, Rene
Bijlsma, J W J #
Issue Date: Jul-2013
Publisher: H.K. Lewis
Series Title: Annals of the Rheumatic Diseases vol:72 issue:12 pages:1905-1913
Article number: 10.1136/annrheumdis-2013-203249
Abstract: To develop recommendations for the management of medium to high-dose (ie, >7.5 mg but ≤100 mg prednisone equivalent daily) systemic glucocorticoid (GC) therapy in rheumatic diseases.A multidisciplinary EULAR task force was formed, including rheumatic patients. After discussing the results of a general initial search on risks of GC therapy, each participant contributed 10 propositions on key clinical topics concerning the safe use of medium to high-dose GCs. The final recommendations were selected via a Delphi consensus approach. A systematic literature search of PubMed, EMBASE and Cochrane Library was used to identify evidence concerning each of the propositions. The strength of recommendation was given according to research evidence, clinical expertise and patient preference.The 10 propositions regarded patient education and informing general practitioners, preventive measures for osteoporosis, optimal GC starting dosages, risk-benefit ratio of GC treatment, GC sparing therapy, screening for comorbidity, and monitoring for adverse effects. In general, evidence supporting the recommendations proved to be surprisingly weak. One of the recommendations was rejected, because of conflicting literature data.Nine final recommendations for the management of medium to high-dose systemic GC therapy in rheumatic diseases were selected and evaluated with their strengths of recommendations. Robust evidence was often lacking; a research agenda was created.
ISSN: 0003-4967
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Skeletal Biology and Engineering Research Center (+)
× corresponding author
# (joint) last author

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