Guidelines

Book

Overview

Clinical guidelines are our key activity supporting evidence-based clinical practice in rheumatology. All of these guidelines are published in our journal Rheumatology under an ‘open access’ licence.

NICE accredits the process we use to produce our clinical guidelines. Accreditation is valid for five years from February 2018. For full details on accreditation visit their website.

Our guidelines grow out of the collaborative efforts of many members and non-members, specialists and generalists, patients and carers and all the MDT.

They are firmly embedded in practice – users lead the proposal, selection and development of all guideline topics – choosing areas where there is clinical uncertainty, where mortality or morbidity can be reduced and where NICE or other guide producers are unlikely to tread.

We neither seek nor accept industry funding for any of our guidelines. Their development is supported through our general finances.

Creating our guidelines is a major voluntary endeavour by members, patients and practitioners from primary care and other specialities. We are grateful to everyone for their strenuous efforts in producing them.

Current guidelines

Biological DMARD safety	Guideline for the safe prescribing of biologics in adults with inflammatory arthritis. Executive summary Full guideline
Lupus	Guideline for the management of adults with Systemic Lupus Erythematosus. 2017 NICE-accredited. Due for revision 2020 Executive summary Full guideline Audit tool Podcast
Sjögren’s Syndrome	Guideline for the management of adults with Primary Sjögren’s Syndrome. 2017 NICE-accredited. Due for revision 2020 Executive summary Full guideline Audit tool Podcast
Gout	Guideline for the management of gout. 2017 NICE-accredited. Due for revision 2020. Executive summary Full guideline Audit tool Podcast
DMARDs	Guideline for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs. 2017 NICE-accredited. Due for revision 2020. Executive summary Full guideline Audit tool Podcast
Axial spondyloarthritis	Guideline for the treatment of axial spondyloarthritis (including ankylosing spondylitis) with biologics. 2016 NICE-accredited. Due for revision 2019. Executive summary Full guideline Audit tool Podcast
Systemic sclerosis	Guideline for the treatment of systemic sclerosis. 2016 NICE-accredited. Due for revision in 2019 Executive summary Full guideline Audit (See page 10 of the full GL for guidance on audit) Podcast
Pregnancy and breastfeeding: Part 1	Guideline on prescribing drugs in pregnancy and breastfeeding Part 1: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. 2016 NICE-accredited. Due for revision in 2019. Executive summary Full guideline Audit tool Podcast
Pregnancy and breastfeeding: Part 2	Guideline on prescribing drugs in pregnancy and breastfeeding Part 2: analgesics and drugs used in rheumatology practice. 2016 NICE-accredited. Due for revision in 2019. Executive summary Full guideline Audit tool Podcast
PsA with biologics	Guideline for the treatment of psoriatic arthritis with biologics. 2013 NICE-accredited. In revision 2019. Executive summary Full guideline PsA guidelines revision statement
Hot swollen joint	Guideline for management of hot swollen joint in adults. The guideline for the management of the hot swollen joint was first published in 2006. Although there is not enough data to constitute a change in the guideline, there is sufficient new information to warrant an update within the next two years. Read the accompanying statement (issued March 2017) for more detail. Renewed and accepted unchanged in 2012. Reviewed again in 2017. An update of the guideline will be due within the next two years. Due for revision in 2019. Executive summary Full guideline Hot Joint guideline update
Polymyalgia rheumatica	Guideline for the management of polymyalgia rheumatica. SAGWG decided that the 2009 guideline, originally due for review 2015, remains current. It is substantially the same as the new 2015 EULAR/ACR guideline: Recommendations for the Management of Polymyalgia Rheumatica. Due for revision in 2019. Executive summary Full guideline
ANCA-associated vasculitis	Guideline for the management of adults with ANCA-associated vasculitis. In revision 2019. Executive summary Full guideline and suggestions for audit

Guidelines under revision

DRAFT REVISION Giant cell arteritis Open for consultation until noon 15 August 2019	The guideline on the management of patients with giant cell arteritis has now reached the 'Open Consultation' phase. This is your chance to review it and suggest changes before final publication. Please click the arrow to see the guideline and audit tool. Please submit your completed comments for either or both sections of the guideline or audit tool to guidelines@rheumatology.org.uk. Executive summary Guideline Audit Tool Comments form
PsA with biologics	The treatment of PsA with biologics. Executive summary
ANCA associated vasculitis	The management of adults with ANCA associated vasculitis. Executive summary

Guidelines in development

Adult patients with idiopathic inflammatory myopathy	Management of adult patients with idiopathic inflammatory myopathy (myositis)
Paediatric patients with idiopathic inflammatory myopathy	Management of paediatric patients with idiopathic inflammatory myopathy (myositis)
Foot health in inflammatory arthritis	Management of foot health in patients with inflammatory arthritis

Propose a new guideline

Propose a topic

The Standards, Audit and Guidelines Working Group (SAGWG) welcomes suggestions for new evidence-based guidelines from our membership and the wider rheumatology community. Suggestions are considered at an annual meeting in September/October, and are due by 31 August.

The guideline development process has been accredited by NICE. This recognises organisations that demonstrate high standards in producing health or social care guidance. All users of our accredited guidance can be confident in the quality of the final guidance documents.

Topics normally fall into one or more of the following categories:

Where there is clinical uncertainty as evidenced by wide variation in practice or outcomes
Where there’s a condition where treatment is proven but mortality or morbidity can be reduced
It's an area where NICE or other guide producer are unlikely to treat

To help you format your submission, please follow these points. Each proposal should include:

A short title and the specific objective(s) for the proposed guideline
An overview (two pages) of the topic that highlight relevant background information (with key supporting references)

Each proposal should address the following:

Is the burden/importance of the condition/health care intervention large enough to warrant guideline development? Please provide some estimate of the burden (e.g., incidence, prevalence, costs)
Is there uncertainty or controversy about the relative effectiveness of the available clinical strategies for the condition(s) for which a guideline is proposed? Please provide some examples/assessment of this uncertainty
Is there perceived or documented variation in practice in the management of a given condition or use of a particular health care intervention? Please provide some assessment/references related to significant differences in practice patterns
Is there sufficient scientific evidence of good quality to allow development of a guideline? Please provide some references, in particular, randomised controlled studies, to support the development of systematic reviews and analysis of the topic
Are there existing guidelines on the proposed topic? If a guideline were to be developed, assuming appropriate dissemination, do you believe that it would make a significant impact on clinical decision-making/clinical outcomes and/or reduce practice variation?

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Guidelines

Overview

Clinical guidelines are our key activity supporting evidence-based clinical practice in rheumatology. All of these guidelines are published in our journal Rheumatology under an ‘open access’ licence.

NICE accredits the process we use to produce our clinical guidelines. Accreditation is valid for five years from February 2018. For full details on accreditation visit their website.

Our guidelines grow out of the collaborative efforts of many members and non-members, specialists and generalists, patients and carers and all the MDT.

They are firmly embedded in practice – users lead the proposal, selection and development of all guideline topics – choosing areas where there is clinical uncertainty, where mortality or morbidity can be reduced and where NICE or other guide producers are unlikely to tread.

We neither seek nor accept industry funding for any of our guidelines. Their development is supported through our general finances.

Creating our guidelines is a major voluntary endeavour by members, patients and practitioners from primary care and other specialities. We are grateful to everyone for their strenuous efforts in producing them.

Current guidelines

Guidelines under revision

Guidelines in development

Propose a new guideline

Propose a topic

The Standards, Audit and Guidelines Working Group (SAGWG) welcomes suggestions for new evidence-based guidelines from our membership and the wider rheumatology community. Suggestions are considered at an annual meeting in September/October, and are due by 31 August.

The guideline development process has been accredited by NICE. This recognises organisations that demonstrate high standards in producing health or social care guidance. All users of our accredited guidance can be confident in the quality of the final guidance documents.

Topics normally fall into one or more of the following categories:

Where there is clinical uncertainty as evidenced by wide variation in practice or outcomes

Where there’s a condition where treatment is proven but mortality or morbidity can be reduced

It's an area where NICE or other guide producer are unlikely to treat

To help you format your submission, please follow these points. Each proposal should include:

A short title and the specific objective(s) for the proposed guideline

An overview (two pages) of the topic that highlight relevant background information (with key supporting references)

Each proposal should address the following:

Is the burden/importance of the condition/health care intervention large enough to warrant guideline development? Please provide some estimate of the burden (e.g., incidence, prevalence, costs)

Is there uncertainty or controversy about the relative effectiveness of the available clinical strategies for the condition(s) for which a guideline is proposed? Please provide some examples/assessment of this uncertainty

Is there perceived or documented variation in practice in the management of a given condition or use of a particular health care intervention? Please provide some assessment/references related to significant differences in practice patterns

Is there sufficient scientific evidence of good quality to allow development of a guideline? Please provide some references, in particular, randomised controlled studies, to support the development of systematic reviews and analysis of the topic

Are there existing guidelines on the proposed topic? If a guideline were to be developed, assuming appropriate dissemination, do you believe that it would make a significant impact on clinical decision-making/clinical outcomes and/or reduce practice variation?