Corradini, D, Di Matteo, A, Emery, P orcid.org/0000-0002-7429-8482 et al. (1 more author) (2021) How should we treat palindromic rheumatism? A systematic literature review. Arthritis and Rheumatology, 51 (1). pp. 266-277. ISSN 2326-5191
Abstract
Objectives:
To perform a systematic literature review (SLR) analysing all studies that reported on the efficacy and safety of pharmacological treatments for palindromic rheumatism (PR).
Methods:
We performed a SLR using PubMed, Embase and Cochrane databases. Three main aspects of PR were considered: treating flares, preventing recurrence of flares (i.e. achieving remission), and preventing progression to RA or to other persistent arthritis. Quality assessment of the studies was performed using the Newcastle-Ottawa Scale (NOS).
Results:
Twenty-seven articles met the inclusion criteria: 6 (22.2%) retrospective studies, 8 (29.6%) longitudinal studies, and 13 (48.1%) case series/case reports. No randomized controlled trials (RCTs) were found. Most of the studies (21/27, 77.7%) had a high risk of bias according to NOS. Non-steroidal anti-inflammatory drugs were the most commonly reported treatments for flares of PR, with variable results. Anti-malarials, such as hydroxychloroquine and chloroquine phosphate, showed efficacy in reducing the frequency of the flares and, to a lesser extent, in preventing progression to RA. There was minimal evidence in support of other conventional/biological disease modifying anti-rheumatic treatments, or corticosteroids.
Conclusion:
Although a frequent clinical dilemma for rheumatologists, the pharmacological management of PR has not been thoroughly evaluated, with no RCTs reported. Of all therapies, antimalarials have been the best studied and may be capable of reducing the recurrence of flares. The optimum treatment strategy for PR remains largely undefined and should be evaluated by robust RCTs in well-defined PR cohorts.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Elsevier Inc. All rights reserved. This is an author produced version of an article published in Seminars in Arthritis and Rheumatism. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Experimental Musculoskeletal Medicine (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Inflammatory Arthritis (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 Dec 2020 15:44 |
Last Modified: | 18 Dec 2021 01:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1016/j.semarthrit.2020.11.008 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:168542 |