The European League Against Rheumatism (EULAR) has published updated recommendations for the management of hand osteoarthritis (OA). This is the first time the 2007 guidelines have been updated.
The 2018 guidance contains five overarching principles and 10 recommendations, including two new additions (#8, #10).
Recommendation 8 advises that patients with hand OA should not be treated with conventional or biological disease-modifying antirheumatic drugs (DMARDs). Recommendation 10 states that long-term follow-up should be adapted to the patient’s individual needs.
One of the 2007 recommendations has been split into two (#1, #2) and two have been combined into one (#5). The 2007 recommendation that local application of heat (especially before exercise) and ultrasound are beneficial treatments, has been removed.
In the updated guidance, recommendations 1-3 address non-pharmacological treatment options, while 4-5 focus on pharmacological therapies, including topical treatments, oral analgesics, chondroitin sulfate, intra-articular glucocorticoids, and conventional/biological DMARDs. Considerations for surgery are described in recommendation 9 and the last recommendation provides guidance on appropriate follow-up.
These are the first recommendations specifically for the management of hand OA to be developed by an international multidisciplinary group.