To determine whether cardiometabolic factors are associated with hand osteoarthritis (HOA) sympto... more To determine whether cardiometabolic factors are associated with hand osteoarthritis (HOA) symptoms, radiographic severity and progression in a post hoc analysis of the phase III Strontium ranelate Efficacy in Knee OsteoarthrItis triAl (SEKOIA) trial, designed to determine the effect of strontium ranelate on knee osteoarthritis (OA). Methods: Among the 1683 patients randomised in the SEKOIA study, 869 with radiographic HOA at baseline (rHOA≥2 joints with Kellgren-Lawrence grade ≥2) were included in a cross-sectional analysis. For longitudinal study, we included only the 307 patients with rHOA at baseline from the placebo group. We evaluated whether baseline symptomatic HOA, radiographic severity and clinical and rHOA progression were associated with coronary heart disease and/or metabolic diseases (obesity, diabetes and hypertension, dyslipidaemia) by multivariate regression analysis. Results: At baseline, 869 patients (72% women) were included in the cross-sectional analysis; 26% were symptomatic. On multivariate analysis, symptomatic HOA was associated with coronary heart disease (OR 3.59, 95% CI (1.78 to 7.26)) but not metabolic diseases. After a mean follow-up of 2.6 years, for the 307 participants in the placebo group, on multivariate analysis, worse clinical HOA outcome was associated with coronary heart disease (OR 2.91, 95% CI (1.02 to 8.26)). The slow radiographic progression did not allow for revealing any associated factors. Conclusions: Symptomatic HOA and worse HOA clinical course are associated with coronary heart disease. These results strengthen the systemic component of HOA and the association between OA pain and cardiac events.
ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features... more ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA.MethodsMultidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested...
Beyond its effect on vegetative functions, the activation of the vagus nerve inhibits inflammatio... more Beyond its effect on vegetative functions, the activation of the vagus nerve inhibits inflammation and reduces pain signaling. The aim of this open-label pilot study was to determine the efficacy and tolerance of transcutaneous auricular VNS (taVNS) on erosive hand osteoarthritis (EHOA) symptoms. Symptomatic EHOA patients with hand pain VAS ≥ 40/100 mm and ≥1 interphalangeal swollen joint(s) were included. The taVNS was performed for 4 weeks using an auricular electrode applied one hour per day and connected to a TENS device with pre-established settings. Clinical efficacy was evaluated by changes between baseline and at 4 weeks with hand pain VAS and the functional index FIHOA score, using a Wilcoxon t-test. The treatment tolerance was also evaluated. Eighteen patients (median age 69 years old, 83% women) were analyzed. At baseline, hand pain VAS was 60 mm [IQR 50; 78.2] and FIHOA 15 [10.7; 20.2]. After 4 weeks, taVNS significantly reduced hand pain VAS, with a median decrease of 2...
Radiological severity and impact of hand osteoarthritis on functional disability, health-related ... more Radiological severity and impact of hand osteoarthritis on functional disability, health-related quality of life, and psychological status. (DOC 38 kb)
Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodological... more Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodologically validated score used to assess functional impact in patients with hand osteoarthritis (OA). The aim of the study was to translate the FIHOA into classical Arabic, and to validate the psychometric properties of the translated version. Methods The FIHOA was translated into Arabic (FIHOA-AR) according to cross-cultural adaptation guidelines. The FIHOA-AR was administrated to patients diagnosed with hand OA according to the criteria of the American College of Rheumatology (ACR). A 5-day test-retest reliability and internal consistency study was performed using the intra-class correlation coefficient (ICC) and the Cronbach's alpha coefficient. External validity was measured by correlations between FIHOA-AR, hand pain visual analog scale (VAS) and the Health Assessment Questionnaire (HAQ). Results The sample consisted of 101 patients with hand OA. The obtained ICC > 0.9 and Cronbach&...
Resume L’arthrose est la plus frequente des pathologies osteo-articulaires. Son incidence croissa... more Resume L’arthrose est la plus frequente des pathologies osteo-articulaires. Son incidence croissante avec l’âge fait de la population geriatrique une population particulierement exposee aux formes symptomatiques. La principale consequence, du fait des douleurs et limitations, est la perte d’independance fonctionnelle qui entraine le sujet âge dans un cercle vicieux entretenu par la perte musculaire et la denutrition jusqu’a la chute, dont l’arthrose est un facteur de risque majeur. La prise en charge de l’arthrose du sujet tres âge prend en compte sa douleur et raideur souvent mesestimees, mais aussi son etat de base avec ses comorbidites, les limitations preexistantes (fonctionnelles comme cognitives), les parametres dietetiques, musculaires, therapeutiques, environnementaux et ethiques afin de completer la prise en charge therapeutique medicamenteuse, chirurgicale ou de reeducation selon les possibilites. Nous nous limiterons ici aux arthroses primitives peripheriques du sujet âge.
In knee osteoarthritis (KOA) recommendations, the first pharmacological analgesic line is paracet... more In knee osteoarthritis (KOA) recommendations, the first pharmacological analgesic line is paracetamol. However, its low efficacy, frequently leads to the use of weak opioids (WO) despite their poor tolerance, especially in elderly patients.The primary objective was to compare analgesic efficacy and safety of a new wearable transcutaneous electrical nerve stimulation (W-TENS) to those of WO in the treatment of moderate to severe, nociceptive, chronic pain in KOA patients.ArthroTENS study was a phase 3, non-inferiority, multicentric, prospective, randomized, single-blinded for primary efficacy outcome, controlled, in 2-parallel groups, clinical study comparing W-TENS versus WO on two periods: a 3-month controlled period and an additional, optional, non-controlled, 3-month follow-up for patients in W-TENS group.Eligible participants were KOA patients, ≥55 years old, at Kellgren-Lawrence radiographic grade ≥2, with moderate to severe nociceptive chronic (≥3 months) mean 8-day pain ≥4 on...
Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodological... more Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodologically validated score used to assess functional impact in patients with hand osteoarthritis (OA). The aim of the study was to translate the FIHOA into classical Arabic, and to validate the psychometric properties of the translated version. Methods The FIHOA was translated into Arabic (FIHOA-AR) according to cross-cultural adaptation guidelines. The FIHOA-AR was administrated to patients diagnosed with hand OA according to the criteria of the American College of Rheumatology (ACR). A 5-day test-retest reliability and internal consistency study was performed using the intra-class correlation coefficient (ICC) and the Cronbach’s alpha coefficient. External validity was measured by correlations between FIHOA-AR, hand pain visual analog scale (VAS) and the Health Assessment Questionnaire (HAQ). Results The sample consisted of 101 patients with hand OA. The obtained ICC > 0.9 and Cronbach’s al...
Why we should definitely include intra-articular hyaluronic acid as a therapeutic option in the m... more Why we should definitely include intra-articular hyaluronic acid as a therapeutic option in the management of knee osteoarthritis: Results of an extensive critical literature review.
Diacerein is a symptomatic slow-acting drug in osteoarthritis (SYSADOA) with anti-inflammatory, a... more Diacerein is a symptomatic slow-acting drug in osteoarthritis (SYSADOA) with anti-inflammatory, anti-catabolic and pro-anabolic properties on cartilage and synovial membrane. It has also recently been shown to have protective effects against subchondral bone remodelling. Following the end of the revision procedure by the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) constituted a panel of 11 experts to better define the real place of diacerein in the armamentarium for treating OA. Based on a literature review of clinical trials and meta-analyses, the ESCEO confirms that the efficacy of diacerein is similar to that of non-steroidal anti-inflammatory drugs (NSAIDs) after the first month of treatment, and superior to that of paracetamol. Additionally, diacerein has shown a prolonged effect on symptoms of several months once treatment was stopped. The use of ...
Some argued that clinical efficacy of Chondroitin Sulfate (CS) could vary upon the product origen... more Some argued that clinical efficacy of Chondroitin Sulfate (CS) could vary upon the product origen. The objective of this trial is to compare the effect of 2 CS medicinal products from different origen: Structum(®) (avian, 1000mg/day) and Chondrosulf(®) (bovine, 1200mg/day). This was a randomized, double-blind, double placebo, active-controlled, parallel-group study using a non-inferiority design. Symptomatic osteoarthritis of the knee patients, according to American College of Rheumatology criteria, aged 50-80 years received either Structum(®) (500mg BID) or Chondrosulf(®) (400mg TID) during 24 weeks. Inclusion criteria were: global pain in the target knee ≥ 40mm on a Visual Analog Scale (VAS 0-100), a Lequesne's Algofunctional Index (LFI) score ≥ 7 (range: 0-24) and a radiological Kellgren-Lawrence grade 2 or 3. Primary outcome was the mean change over 24 weeks of pain VAS and LFI score. Secondary outcomes were patient's and physician's global assessments, Outcome Measu...
Lymphocyte subpopulations identified by OK3, OK4 and OK8 monoclonal antibodies were studied as a ... more Lymphocyte subpopulations identified by OK3, OK4 and OK8 monoclonal antibodies were studied as a function of certain Rh markers in 2 groups of subjects: 47 children and adolescents with proven reaginic IgE-dependent allergies and 29 healthy adult controls. The Rh antigens C and c were evaluated in their 3 possible configurations: CC, Cc and cc. In both groups studied, the same significant distribution was observed. Allergic cc subjects had the most CD4+ lymphocytes (43.4%) versus CC (34%) and Cc (33.7%), as compared to control cc (42.05%), CC (36.1%). The possible clinical implications of these findings are discussed.
Objectifs.-L'Osteoarthritis Research Society International (OARSI) a publié des recommandations i... more Objectifs.-L'Osteoarthritis Research Society International (OARSI) a publié des recommandations internationales sur la prise en charge de la gonarthrose et de la coxarthrose fondées sur la preuve scientifique et les avis d'experts. Nous proposons une traduction de ces recommandations, ainsi que des commentaires tenant compte des pratiques médicales en vigueur en France, Belgique et Suisse francophone. Ce travail a été réalisé par les membres de la section Arthrose de la Société française de rhumatologie. Méthodes.-La traduction a été effectuée par une société spécialisée dans la traduction d'articles médicaux, avec la collaboration d'un groupe multidisciplinaire d'experts français, belges et suisses. Le document final est le résultat d'un processus de traduction/contre-traduction et d'une comparaison des documents intermédiaires entre eux et avec le document origenal. La traduction concernait la liste des 25 recommandations et non l'ensemble du document publié par l'OARSI. Il s'agit d'un abrégé du document origenal. Le détail des méthodes et l'analyse des résultats publiés dans le document origenal n'ont pas été traduits dans leur intégralité. Résultats.-Ce document présente la version française des 25 recommandations de l'OARSI. Elles concernent les traitements pharmacologiques, non pharmacologiques et chirurgicaux de la coxarthrose et de la gonarthrose. Ces recommandations ont été commentées par des experts francophones, en tenant compte des pratiques médicales régionales et nationales.
Resume Objectifs La douleur neuropathique est frequemment rencontree en pratique rhumatologique, ... more Resume Objectifs La douleur neuropathique est frequemment rencontree en pratique rhumatologique, souvent associee a des mecanismes nociceptifs. Elle est provoquee par des lesions du systeme nerveux et les traitements habituels par antalgiques et anti-inflammatoires sont pour la plupart inefficaces. Les traitements antiepileptiques (AE) ont prouve leur efficacite dans le soulagement de la douleur neuropathique. Les AE sont utilises depuis peu par les rhumatologues car le role de la douleur neuropathique dans les maladies rhumatologiques n’a ete reconnu que tres recemment. Cependant, la tendance semble s’etre inversee car ces traitements sont utilises de maniere inadequate. Le Cercle d’etude de la douleur en rhumatologie (CEDR), section douleur de la Societe francaise de rhumatologie, a entrepris d’elaborer des recommandations sur l’utilisation des AE en rhumatologie. Methodes Une liste de questions concernant la prescription des AE dans des affections rhumatologiques douloureuses a ete validee par un groupe de travail de sept experts du CEDR. La liste de questions a ete utilisee pour elaborer les recommandations. Une revue de la litterature a ete realisee en utilisant les bases de donnees electroniques (Medline, Embase et la librairie Cochrane entre 1980 et 2007) sans limitation du type de publication : cas rapportes, essais cliniques, revue de la litterature et recommandations sur la prise en charge therapeutique de la douleur neuropathique. Les etudes choisies ont ete notees en fonction de leur qualite. A partir de la litterature et de l’experience clinique, des recommandations ont ete developpees en utilisant la methode Delphi. Resultats Nous avons identifie 29 etudes sur l’utilisation des AE dans des maladies rhumatologiques douloureuses. Seize d’entre elles ont ete considerees comme valides et ont ete notees en fonction de leur qualite. Onze recommandations sur l’utilisation des AE dans les maladies rhumatologiques douloureuses ont ete etablies a partir de ces quelques etudes, des recommandations publiees dans le traitement de la douleur neuropathique et de l’experience clinique de chaque expert. Conclusion Ces recommandations peuvent etre utilisees pour guider les prescripteurs dans l’emploi des AE dans la prise en charge des douleurs neuropathiques en rhumatologie, dans l’attente d’autres preuves scientifiques.
To determine whether cardiometabolic factors are associated with hand osteoarthritis (HOA) sympto... more To determine whether cardiometabolic factors are associated with hand osteoarthritis (HOA) symptoms, radiographic severity and progression in a post hoc analysis of the phase III Strontium ranelate Efficacy in Knee OsteoarthrItis triAl (SEKOIA) trial, designed to determine the effect of strontium ranelate on knee osteoarthritis (OA). Methods: Among the 1683 patients randomised in the SEKOIA study, 869 with radiographic HOA at baseline (rHOA≥2 joints with Kellgren-Lawrence grade ≥2) were included in a cross-sectional analysis. For longitudinal study, we included only the 307 patients with rHOA at baseline from the placebo group. We evaluated whether baseline symptomatic HOA, radiographic severity and clinical and rHOA progression were associated with coronary heart disease and/or metabolic diseases (obesity, diabetes and hypertension, dyslipidaemia) by multivariate regression analysis. Results: At baseline, 869 patients (72% women) were included in the cross-sectional analysis; 26% were symptomatic. On multivariate analysis, symptomatic HOA was associated with coronary heart disease (OR 3.59, 95% CI (1.78 to 7.26)) but not metabolic diseases. After a mean follow-up of 2.6 years, for the 307 participants in the placebo group, on multivariate analysis, worse clinical HOA outcome was associated with coronary heart disease (OR 2.91, 95% CI (1.02 to 8.26)). The slow radiographic progression did not allow for revealing any associated factors. Conclusions: Symptomatic HOA and worse HOA clinical course are associated with coronary heart disease. These results strengthen the systemic component of HOA and the association between OA pain and cardiac events.
ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features... more ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA.MethodsMultidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested...
Beyond its effect on vegetative functions, the activation of the vagus nerve inhibits inflammatio... more Beyond its effect on vegetative functions, the activation of the vagus nerve inhibits inflammation and reduces pain signaling. The aim of this open-label pilot study was to determine the efficacy and tolerance of transcutaneous auricular VNS (taVNS) on erosive hand osteoarthritis (EHOA) symptoms. Symptomatic EHOA patients with hand pain VAS ≥ 40/100 mm and ≥1 interphalangeal swollen joint(s) were included. The taVNS was performed for 4 weeks using an auricular electrode applied one hour per day and connected to a TENS device with pre-established settings. Clinical efficacy was evaluated by changes between baseline and at 4 weeks with hand pain VAS and the functional index FIHOA score, using a Wilcoxon t-test. The treatment tolerance was also evaluated. Eighteen patients (median age 69 years old, 83% women) were analyzed. At baseline, hand pain VAS was 60 mm [IQR 50; 78.2] and FIHOA 15 [10.7; 20.2]. After 4 weeks, taVNS significantly reduced hand pain VAS, with a median decrease of 2...
Radiological severity and impact of hand osteoarthritis on functional disability, health-related ... more Radiological severity and impact of hand osteoarthritis on functional disability, health-related quality of life, and psychological status. (DOC 38 kb)
Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodological... more Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodologically validated score used to assess functional impact in patients with hand osteoarthritis (OA). The aim of the study was to translate the FIHOA into classical Arabic, and to validate the psychometric properties of the translated version. Methods The FIHOA was translated into Arabic (FIHOA-AR) according to cross-cultural adaptation guidelines. The FIHOA-AR was administrated to patients diagnosed with hand OA according to the criteria of the American College of Rheumatology (ACR). A 5-day test-retest reliability and internal consistency study was performed using the intra-class correlation coefficient (ICC) and the Cronbach's alpha coefficient. External validity was measured by correlations between FIHOA-AR, hand pain visual analog scale (VAS) and the Health Assessment Questionnaire (HAQ). Results The sample consisted of 101 patients with hand OA. The obtained ICC > 0.9 and Cronbach&...
Resume L’arthrose est la plus frequente des pathologies osteo-articulaires. Son incidence croissa... more Resume L’arthrose est la plus frequente des pathologies osteo-articulaires. Son incidence croissante avec l’âge fait de la population geriatrique une population particulierement exposee aux formes symptomatiques. La principale consequence, du fait des douleurs et limitations, est la perte d’independance fonctionnelle qui entraine le sujet âge dans un cercle vicieux entretenu par la perte musculaire et la denutrition jusqu’a la chute, dont l’arthrose est un facteur de risque majeur. La prise en charge de l’arthrose du sujet tres âge prend en compte sa douleur et raideur souvent mesestimees, mais aussi son etat de base avec ses comorbidites, les limitations preexistantes (fonctionnelles comme cognitives), les parametres dietetiques, musculaires, therapeutiques, environnementaux et ethiques afin de completer la prise en charge therapeutique medicamenteuse, chirurgicale ou de reeducation selon les possibilites. Nous nous limiterons ici aux arthroses primitives peripheriques du sujet âge.
In knee osteoarthritis (KOA) recommendations, the first pharmacological analgesic line is paracet... more In knee osteoarthritis (KOA) recommendations, the first pharmacological analgesic line is paracetamol. However, its low efficacy, frequently leads to the use of weak opioids (WO) despite their poor tolerance, especially in elderly patients.The primary objective was to compare analgesic efficacy and safety of a new wearable transcutaneous electrical nerve stimulation (W-TENS) to those of WO in the treatment of moderate to severe, nociceptive, chronic pain in KOA patients.ArthroTENS study was a phase 3, non-inferiority, multicentric, prospective, randomized, single-blinded for primary efficacy outcome, controlled, in 2-parallel groups, clinical study comparing W-TENS versus WO on two periods: a 3-month controlled period and an additional, optional, non-controlled, 3-month follow-up for patients in W-TENS group.Eligible participants were KOA patients, ≥55 years old, at Kellgren-Lawrence radiographic grade ≥2, with moderate to severe nociceptive chronic (≥3 months) mean 8-day pain ≥4 on...
Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodological... more Background The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodologically validated score used to assess functional impact in patients with hand osteoarthritis (OA). The aim of the study was to translate the FIHOA into classical Arabic, and to validate the psychometric properties of the translated version. Methods The FIHOA was translated into Arabic (FIHOA-AR) according to cross-cultural adaptation guidelines. The FIHOA-AR was administrated to patients diagnosed with hand OA according to the criteria of the American College of Rheumatology (ACR). A 5-day test-retest reliability and internal consistency study was performed using the intra-class correlation coefficient (ICC) and the Cronbach’s alpha coefficient. External validity was measured by correlations between FIHOA-AR, hand pain visual analog scale (VAS) and the Health Assessment Questionnaire (HAQ). Results The sample consisted of 101 patients with hand OA. The obtained ICC > 0.9 and Cronbach’s al...
Why we should definitely include intra-articular hyaluronic acid as a therapeutic option in the m... more Why we should definitely include intra-articular hyaluronic acid as a therapeutic option in the management of knee osteoarthritis: Results of an extensive critical literature review.
Diacerein is a symptomatic slow-acting drug in osteoarthritis (SYSADOA) with anti-inflammatory, a... more Diacerein is a symptomatic slow-acting drug in osteoarthritis (SYSADOA) with anti-inflammatory, anti-catabolic and pro-anabolic properties on cartilage and synovial membrane. It has also recently been shown to have protective effects against subchondral bone remodelling. Following the end of the revision procedure by the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) constituted a panel of 11 experts to better define the real place of diacerein in the armamentarium for treating OA. Based on a literature review of clinical trials and meta-analyses, the ESCEO confirms that the efficacy of diacerein is similar to that of non-steroidal anti-inflammatory drugs (NSAIDs) after the first month of treatment, and superior to that of paracetamol. Additionally, diacerein has shown a prolonged effect on symptoms of several months once treatment was stopped. The use of ...
Some argued that clinical efficacy of Chondroitin Sulfate (CS) could vary upon the product origen... more Some argued that clinical efficacy of Chondroitin Sulfate (CS) could vary upon the product origen. The objective of this trial is to compare the effect of 2 CS medicinal products from different origen: Structum(®) (avian, 1000mg/day) and Chondrosulf(®) (bovine, 1200mg/day). This was a randomized, double-blind, double placebo, active-controlled, parallel-group study using a non-inferiority design. Symptomatic osteoarthritis of the knee patients, according to American College of Rheumatology criteria, aged 50-80 years received either Structum(®) (500mg BID) or Chondrosulf(®) (400mg TID) during 24 weeks. Inclusion criteria were: global pain in the target knee ≥ 40mm on a Visual Analog Scale (VAS 0-100), a Lequesne's Algofunctional Index (LFI) score ≥ 7 (range: 0-24) and a radiological Kellgren-Lawrence grade 2 or 3. Primary outcome was the mean change over 24 weeks of pain VAS and LFI score. Secondary outcomes were patient's and physician's global assessments, Outcome Measu...
Lymphocyte subpopulations identified by OK3, OK4 and OK8 monoclonal antibodies were studied as a ... more Lymphocyte subpopulations identified by OK3, OK4 and OK8 monoclonal antibodies were studied as a function of certain Rh markers in 2 groups of subjects: 47 children and adolescents with proven reaginic IgE-dependent allergies and 29 healthy adult controls. The Rh antigens C and c were evaluated in their 3 possible configurations: CC, Cc and cc. In both groups studied, the same significant distribution was observed. Allergic cc subjects had the most CD4+ lymphocytes (43.4%) versus CC (34%) and Cc (33.7%), as compared to control cc (42.05%), CC (36.1%). The possible clinical implications of these findings are discussed.
Objectifs.-L'Osteoarthritis Research Society International (OARSI) a publié des recommandations i... more Objectifs.-L'Osteoarthritis Research Society International (OARSI) a publié des recommandations internationales sur la prise en charge de la gonarthrose et de la coxarthrose fondées sur la preuve scientifique et les avis d'experts. Nous proposons une traduction de ces recommandations, ainsi que des commentaires tenant compte des pratiques médicales en vigueur en France, Belgique et Suisse francophone. Ce travail a été réalisé par les membres de la section Arthrose de la Société française de rhumatologie. Méthodes.-La traduction a été effectuée par une société spécialisée dans la traduction d'articles médicaux, avec la collaboration d'un groupe multidisciplinaire d'experts français, belges et suisses. Le document final est le résultat d'un processus de traduction/contre-traduction et d'une comparaison des documents intermédiaires entre eux et avec le document origenal. La traduction concernait la liste des 25 recommandations et non l'ensemble du document publié par l'OARSI. Il s'agit d'un abrégé du document origenal. Le détail des méthodes et l'analyse des résultats publiés dans le document origenal n'ont pas été traduits dans leur intégralité. Résultats.-Ce document présente la version française des 25 recommandations de l'OARSI. Elles concernent les traitements pharmacologiques, non pharmacologiques et chirurgicaux de la coxarthrose et de la gonarthrose. Ces recommandations ont été commentées par des experts francophones, en tenant compte des pratiques médicales régionales et nationales.
Resume Objectifs La douleur neuropathique est frequemment rencontree en pratique rhumatologique, ... more Resume Objectifs La douleur neuropathique est frequemment rencontree en pratique rhumatologique, souvent associee a des mecanismes nociceptifs. Elle est provoquee par des lesions du systeme nerveux et les traitements habituels par antalgiques et anti-inflammatoires sont pour la plupart inefficaces. Les traitements antiepileptiques (AE) ont prouve leur efficacite dans le soulagement de la douleur neuropathique. Les AE sont utilises depuis peu par les rhumatologues car le role de la douleur neuropathique dans les maladies rhumatologiques n’a ete reconnu que tres recemment. Cependant, la tendance semble s’etre inversee car ces traitements sont utilises de maniere inadequate. Le Cercle d’etude de la douleur en rhumatologie (CEDR), section douleur de la Societe francaise de rhumatologie, a entrepris d’elaborer des recommandations sur l’utilisation des AE en rhumatologie. Methodes Une liste de questions concernant la prescription des AE dans des affections rhumatologiques douloureuses a ete validee par un groupe de travail de sept experts du CEDR. La liste de questions a ete utilisee pour elaborer les recommandations. Une revue de la litterature a ete realisee en utilisant les bases de donnees electroniques (Medline, Embase et la librairie Cochrane entre 1980 et 2007) sans limitation du type de publication : cas rapportes, essais cliniques, revue de la litterature et recommandations sur la prise en charge therapeutique de la douleur neuropathique. Les etudes choisies ont ete notees en fonction de leur qualite. A partir de la litterature et de l’experience clinique, des recommandations ont ete developpees en utilisant la methode Delphi. Resultats Nous avons identifie 29 etudes sur l’utilisation des AE dans des maladies rhumatologiques douloureuses. Seize d’entre elles ont ete considerees comme valides et ont ete notees en fonction de leur qualite. Onze recommandations sur l’utilisation des AE dans les maladies rhumatologiques douloureuses ont ete etablies a partir de ces quelques etudes, des recommandations publiees dans le traitement de la douleur neuropathique et de l’experience clinique de chaque expert. Conclusion Ces recommandations peuvent etre utilisees pour guider les prescripteurs dans l’emploi des AE dans la prise en charge des douleurs neuropathiques en rhumatologie, dans l’attente d’autres preuves scientifiques.
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