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The Italian Society of Rheumatology clinical practice guidelines for the management of polymyalgia rheumatica
N Ughi1, G D Sebastiani2, R Gerli3
1Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Division of Rheumatology, ASST Grande Ospedale Metropolitano Niguarda, Milano. n.ughi@reumatologia.it.
Objective:
to provide evidence-based up-to-date recommendations for the management of patients with a definite diagnosis of polymyalgia rheumatica (PMR).
Methods:
A systematic literature review was performed to find the existing clinical practice guidelines (CPGs) on PMR and the framework of the Guidelines International Network Adaptation Working Group was used to appraise (AGREE II), synthesize, and customize the recommendations according to the needs of the Italian healthcare context. Rheumatologists on behalf of the Italian Society of Rheumatology (SIR) and from the SIR Epidemiology Unit joined the working group and identified the key health questions on PMR to guide the systematic literature review. Physicians, including general practitioners and specialists, and health professionals who manage PMR in the clinical practice were the target audience. The final recommendations were rated externally by a multi-disciplinary and multi-professional group of stakeholders.
Results:
From the systematic search in databases (Medline, Embase) and grey literature, 3 CPGs were identified and appraised by two independent raters. Combining the statements and the evidence from these CPGs, 9 recommendations were developed by endorsement or adaptation in response to the initial key health questions. The quality of evidence was graded and the working group discussed the final recommendations in view of their implementation in the Italian healthcare context.
Conclusions:
In absence of national guidelines so far, these recommendations are the first to provide guidance for the management of patients with a diagnosis of PMR in Italy and they are expected to ensure the best evidence-based clinical practice for this disease.
Insights
This study presents the first evidence-based guidelines for managing polymyalgia rheumatica (PMR) in Italy. These recommendations aim to standardize and improve clinical practice for PMR patients.
Area of Science:
- Rheumatology
- Clinical Practice Guidelines
Background:
- Polymyalgia rheumatica (PMR) requires standardized management protocols.
- Existing international guidelines needed adaptation for the Italian healthcare context.
Purpose of the Study:
- To develop evidence-based, up-to-date recommendations for PMR patient management in Italy.
- To establish the first national clinical practice guidelines for PMR.
Main Methods:
- Systematic literature review of existing clinical practice guidelines (CPGs) for PMR.
- Appraisal and synthesis of CPGs using the Guidelines International Network Adaptation Working Group framework.
- Customization of recommendations for the Italian healthcare setting by rheumatologists from the Italian Society of Rheumatology (SIR).
Main Results:
- Three CPGs were identified and appraised.
- Nine recommendations were developed through endorsement and adaptation.
- Evidence quality was graded, and recommendations were finalized for Italian implementation.
Conclusions:
- These are the inaugural national guidelines for PMR management in Italy.
- The recommendations are expected to enhance evidence-based clinical practice for PMR.
- Guidance is provided for physicians and health professionals managing PMR.
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