recommendations for the management of gout: therapies and prevention claire bombardier, md, frcpc...
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Recommendations for the management of gout:Therapies and Prevention
Claire Bombardier, MD, FRCPCProfessor of Medicine and Rheumatology Division Director, University of Toronto
Senior Scientist, Institute for Work & Health and TGRI, UHN
Rheumatologist, Mount Sinai Hospital
Canada Research Chair and Co-scientific Director, Canadian Arthritis Network
Alison Kydd, MD, PhD, FRCPCClinical Assistant Professor
Division of Rheumatology
University of British Columbia
Ophir Vinik, MD, MSc, FRCPCAdult Rheumatology Resident
University of Toronto
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3e (evidence, exchange, expertise)topics history
1. 2006-2007: Ankylosing Spondylitis
2. 2007-2008: Use of Methotrexate in Rheumatoid Arthritis
3. 2008-2009: How to investigate and follow-up undifferentiated peripheral inflammatory arthritis?
4. 2010- 2011: Pain management by pharmacotherapy in Inflammatory Arthritis
5. 2011-2012:Diagnosis and management of Gout
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AGREE is an integrated research programme currently funded by the Biomedecine and Health Programme (BIOMED-2) of the European Union.
M Dougados, et al. EULAR standardised operating procedures for the elaboration, evaluation, dissemination, and implementation of recommendations endorsed by the EULAR standing committees. Ann Rheum Dis 2004;63;1172-6.
EULAR and AGREE guidelines
eularMethodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
Methodology The methodology used for the development of 3e recommendations is based on the EULAR and AGREE standardised operating procedures for the elaboration, evaluation, dissemination, and implementation of recommendations.
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3e Initiative general methodology
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
Methodology
EvidenceSystematic Literature Review
ExpertiseRheumatologists
Recommendations
Exchange
Topic & Questions
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Relevant questions for the topic
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
Topic & questions Opening Multinational meeting Proposals made by the national
Steering Committees
Final selection of 10 questionsUsing a modified DELPHI technique, anonymous voting
system…
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Selection of the 10 questionsKickoff meeting – June 24-25, 2011
Proposals made by the national steering committees
Vote session (modified Delphi technique) for the choice of the 10 mutinational questions
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3e initiative 2011-2012
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Multinational level
ChairDésirée van der Heijde
Review and transmission of the SLR results
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
Systematic Literature Review Mentors
Daniel AletahaClaire BombardierRachelle BuchbinderLoreto CarmonaChris EdwardsRobert Landewé
Multi-national fellows
Mariano AndrésAlison Kydd John MoiRakhi SethFrancisca Sivera Mascaró Melonie Sriranganathan Caroline van DurmeIrene van EchteldOphir VinicMihir Wechalekar
LibrarianLouise Falzon
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The systematic literature reviewJuly 2011 – March 2012
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10 Questions
5. Alison Kydd
What is the efficacy, cost-efficacy and safety for ULT (allopurinol, but also febuxostat, peg-uricase, benzbromarone and probenecid) in the treatment of gout? Which sequence of ULT or combinations of should be recommended?
10. Ophir Vinik
Can we prevent gouty arthritis, renal disease and CV events by lowering serum uric acid levels in patients with asymptomatic hyperuricaemia? If yes, what should be the target levels?
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The teams
12 PIs
SWEDEN
Anca CATRINA
DENMARK
Mikkel ØSTERGAARD
THE NETHERLANDS
Hans BIJLSMA
AUSTRIA
Burkhard LEEB
GERMANY
Ulf MULLER-LADNER
AUSTRALIA – NEW ZEALAND
Jane ZOCHLING
BRAZIL
Antonio JoséLOPES FERRARI
MEXICO
Rubén BURGOS VARGAS
UNITED KINGDOM
Patrick KIELY
BELGIUM - LUXEMBOURG
Dirk ELEWAUT
PORTUGAL
Jaime BRANCO
ITALY
CarlomaurizioMONTECUCCO
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National recommendations
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
National recommendations
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Closing meeting
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
Dissemination
Multinational recommendations
Agreement on one set of multinational
recommendations
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3e Initiative 2011-2012 at a glance
FebruarySeptemberJune March-May June …
KickoffAll participants
June 24-25
Bibliographic Meeting
Only multinational mentors and fellows
September 2-3, Prague
SLR Final results
Available on blogMarch 5
Bibliographic Meeting + PIs
PIs, Mentors and Fellows February 2-4, Lisbon
National meetingsMarch to May
Closing MeetingAll participants
June 22-23, Brussels, Dolce
2011 2012
Dissemination…
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Main Paper presenting the recommendations published in ARDAnn Rheum Dis. 2011 Jan;70(1):15-24. Epub 2010 Aug 19.
Publications: example for UPIA
Supplement of the Journal of Rheumatology entirely dedicated
to 3e UPIA with 11 articlesSupplement 87 published in March 2011
Methodology
Topic & questions
Systematic Literature Review
National recommendations
Multinational recommendations
DisseminationDissemination
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3e Pain Publications
Entire supplement of the Journal of Rheumatology dedicated to 3e Painto be published in early September
8 Cochrane reviews
Main Paper published in Rheumatology online March 2012
EULAR 2011:2 oral communications5 posters