Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the

Abstract

Objectives: This study aims to report Turkish League Against Rheumatism's assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey.

Materials and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected.

Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same.

Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics.

C1 [Ataman, Sebnem; Surmeli, Zuhre Sari; Sunar, Ismihan; Ozdemirel, Erhan; Yalcin, Peyman] Ankara Univ, Fac Med, Div Rheumatol, Dept Phys Med & Rehabil, TR-06100 Ankara, Turkey.

[Akinci, Aysen] Hacettepe Univ, Fac Med, Dept Phys Med & Rehabil, TR-06100 Ankara, Turkey.

[Bodur, Hatice] Ankara Numune Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey.

[Akgul, Ozgur; Cerrahoglu, Lale] Celal Bayar Univ, Fac Med, Dept Phys Med & Rehabil, Manisa, Turkey.

[Altan, Lale] Uludag Univ, Fac Med, Dept Phys Med & Rehabil, Bursa, Turkey.

[Altay, Zuhal] Inonu Univ, Fac Med, Dept Phys Med & Rehabil, Malatya, Turkey.

[Ayhan, Figen] Ankara Numune Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey.

[Birtane, Murat] Trakya Univ, Fac Med, Dept Phys Med & Rehabil, Edirne, Turkey.

[Soy Bugdayci, Derya] Istanbul Phys Med & Rehabil Training & Res Hosp, Dept Phys Med & Rehabil, Istanbul, Turkey.

[Capkin, Erhan] Karadeniz Tech Univ, Fac Med, Dept Phys Med & Rehabil, Trabzon, Turkey.

[Duruoz, Mehmet Tuncay] Marmara Univ, Fac Med, Dept Phys Med & Rehabil, Istanbul, Turkey.

[Gunaydin, Rezzan] Ordu Univ, Fac Med, Dept Phys Med & Rehabil, Ordu, Turkey.

[Gunendi, Zafer] Gazi Univ, Fac Med, Dept Phys Med & Rehabil, Ankara, Turkey.

[Gurer, Gulcan; Sendur, Omer Faruk] Adnan Menderes Univ, Fac Med, Dept Phys Med & Rehabil, Aydin, Turkey.

[Bal, Ajda] Diskapi Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey.

[Kacar, Cahit] Akdeniz Univ, Fac Med, Dept Phys Med & Rehabil, TR-07058 Antalya, Turkey.

[Kaptanoglu, Ece] Cumhuriyet Univ, Fac Med, Dept Phys Med & Rehabil, Sivas, Turkey.

[Kaya, Taciser] Izmir Bozyaka Training & Res Hosp, Dept Phys Med & Rehabil, Izmir, Turkey.

[Kocabas, Hilal] Necmettin Erbakan Univ, Meram Fac Med, Dept Phys Med & Rehabil, Konya, Turkey.

[Kotevoglu, Nurdan] Maltepe Univ, Fac Med, Dept Phys Med & Rehabil, Istanbul, Turkey.

[Nas, Kemal] Sakarya Univ, Fac Med, Dept Phys Med & Rehabil, Adapazari, Turkey.

[Rezvani, Aylin] Bezmialem Vakif Univ, Fac Med, Dept Phys Med & Rehabil, Istanbul, Turkey.

[Sen, Nesrin] Elazig Training & Res Hosp, Dept Phys Med & Rehabil, Elazig, Turkey.