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[Determining cardiovascular risk in patients with rheumatoid arthritis: prove the efficacy of interventions first]

Siep Thomas1

  • 1Erasmus Medisch Centrum, afd. Huisartsgeneeskunde, Rotterdam, the Netherlands. s.thomas@erasmusmc.nl

Nederlands Tijdschrift Voor Geneeskunde
|November 17, 2011
PubMed

Insights

The Dutch guideline on Cardiovascular Risk Management needs removal of recommendations for arthritis patients due to lack of trial evidence. Unjustified clinical guidelines with low-grade evidence should be stopped internationally.

Area of Science:

  • Cardiology
  • Rheumatology
  • Evidence-Based Medicine

Background:

  • The 2011 Dutch guideline on Cardiovascular Risk Management includes recommendations for patients with arthritis.
  • These recommendations aim to manage elevated cardiovascular disease risks in this patient group.

Purpose of the Study:

  • To evaluate the trial-based justification for cardiovascular risk management recommendations in arthritis patients.
  • To address the international tendency of introducing clinical guidelines with low-grade evidence.

Main Methods:

  • Review of the 2011 Dutch guideline on Cardiovascular Risk Management.
  • Assessment of the evidence supporting recommendations for arthritis patients.

Main Results:

  • The recommendation for preventive cardiovascular treatment in arthritis patients lacks trial-based justification.
  • The evidence supporting this recommendation is of unacceptably low grade.

Conclusions:

  • The specific recommendation for cardiovascular risk management in arthritis patients should be removed from the guideline.
  • The practice of introducing clinical guidelines with recommendations based on low-grade evidence should be halted.

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