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EULAR recommendations for intra-articular therapies

Research output: Contribution to journalReview articlepeer-review

Jacqueline Uson, Sebastián Cruz Rodriguez-García, Raul Castellanos-Moreira, Terence W. O'Neill, Michael Doherty, Mikael Boesen, Hemant Pandit, Ingrid Möller Parera, Valentina Vardanyan, Lene Terslev, Willm Uwe Kampen, Maria Antonietta D'Agostino, Francis Berenbaum, Elena Nikiphorou, Irene A. Pitsillidou, Jenny De La Torre-Aboki, Loreto Carmona, Esperanza Naredo

Original languageEnglish
Pages (from-to)1299-1305
Number of pages7
JournalAnnals of the rheumatic diseases
Issue number10
Accepted/In press2021
Published1 Oct 2021

Bibliographical note

Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Objectives: To establish evidence-based recommendations to guide health professionals using intra-articular therapies (IAT) in adult patients with peripheral arthropathies. Methods: A multidisciplinary international task force established the objectives, users and scope and the need for background information, including systematic literature reviews) and two surveys addressed to healthcare providers and patients throughout Europe. The evidence was discussed in a face-to-face meeting, recommendations were formulated and subsequently voted for anonymously in a three-round Delphi process to obtain the final agreement. The level of evidence was assigned to each recommendation with the Oxford levels of evidence. Results: Recommendations focus on practical aspects to guide health professionals before, during and after IAT in adult patients with peripheral arthropathies. Five overarching principles and 11 recommendations were established, addressing issues related to patient information, procedure and setting, accuracy, routine and special aseptic care, safety issues and precautions to be addressed in special populations, efficacy and safety of repeated joint injections, use of local anaesthetics and aftercare. Conclusion: We have developed the first evidence and expert opinion-based recommendations to guide health professionals using IAT. We hope that these recommendations will be included in different educational programmes, used by patient associations and put into practice via scientific societies to help improve uniformity and quality of care when performing IAT in peripheral adult joints.

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