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[The Dutch College of General Practitioners' practice guideline on arthritis]
Willem F Lems1, Pit J S M Kerstens
1Vrije Universiteit Medisch Centrum, Afd. Reumatologie, Amsterdam, The Netherlands. wf.lems@vumc.nl
Abstract:
The Dutch College of General Practitioners' new practice guideline on arthritis combines arthritis and gout. One of the important improvements in this guideline is that it recommends that patients be referred to the rheumatologist as soon as 4 weeks after being seen, or earlier, if rheumatoid arthritis is likely or suspected. Obviously, these early referrals are related to the large increase in effective treatment options in rheumatoid arthritis, particularly after early treatment (window of opportunity). The new guideline relating to gout advocates the use of oral prednisone as the second choice in patients without an adequate treatment response or who do not tolerate NSAIDs: colchicine and intra-articular injections may be attractive alternatives.
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