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Öğe Characteristics of patients with rheumatoid arthritis in Turkey: Results from the Turkish league against rheumatism rheumatoid arthritis registry(2015) Bal, Ajda; Ataman, Şebnem; Bodur, Hatice; Rezvani, Aylin; Paker, Nurdan; Taştekin, Nurettin; Uğurlu, Hatice; Göksel Karatepe, Altınay; Borman, Pınar; Yener, Mahmut; Nas, Kemal; Sezgin, Melek; Yazgan, Pelin; Tekeoğlu, İbrahim; Doğu, Beril; Altay, Zuhal; Kırnap, Mehmet; Gürgan, Alev; Gür, Ali; Hizmetli, Sami; Günendi, Zafer; Erdem, Rana; Uğurlu, Hatice; İnal, Elem; Ölmez, Neşe; Kozanoğlu, Erkan; Öken, Öznur; Özel, Sumru; Dündar, Ümit; Akıncı, Ayşen; Öztürk, Cihat; Sivrioğlu, Konçuy; Duruöz, Mehmet Tuncay; Aydoğ, Ece; Çapkın, Erhan; Altan, Lale; Evcik, Deniz; Durmuş, Oğuz; Yağcı, İlker; Şendur, Ömer Faruk; Sertpoyraz, Filiz Meryem; Özgül, Ahmet; Şenel, Kazım; Çapacı, KazımAmaç: Bu çalışmanın amacı Türkiyedeki romatoid artrit hastalarının demografik ve klinik özelliklerini ortaya koyarak bu hastalar için oluşturulabilecek önlem, tedavi ve destek stratejilerine ışık tutmaktır. Hastalar ve yöntemler: Bu çalışma kapsamında Eylül 2007 - Mart 2011 tarihleri arasında Türkiyenin farklı bölgelerindeki toplam 36 merkezden Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) kayıt sistemine kaydedilen 2.359 hasta (1.966 kadın, 393 erkek; ort. yaş 51.612.5 yıl; dağılım 18-75 yıl) değerlendirildi. Hastaların demografik ve klinik verileri kaydedildi. Hastalık aktivitesi, fonksiyonel durum ve radyografik hasar sırasıyla hastalık aktivite skoru 28, sağlık değerlendirme anketi ve van der Heijde modifiye Sharp puanlama yöntemi ile ölçüldü. Bulgular: Akademik eğitim süresi ortalama 5.23.8 yıldı ve hastaların %74.6sı ev hanımıydı. Hastaların %91.0ı biyolojik olmayan hastalık modifiye edici ilaçlar, %10.2si biyolojik hastalık modifiye edici ilaçlar kullanıyordu. Ortalama hastalık aktivite skoru 28, sağlık değerlendirme anketi ve Sharp puanları sırasıyla, 4.01.4, 0.380.37 ve 31.257.1 idi. Hastaların %17.8i remisyonda ve %14.1i düşük hastalık aktivitesinde iken %42.7si orta hastalık aktivitesinde ve %25.5i yüksek hastalık aktivitesinde idi. Sonuç: Türkiyede romatoid artrit hastalarının çoğunluğu orta yaşlı ev hanımlarıdır. Her ne kadar hastalık modifiye edici ilaç kullanımı yüksek oranda ise de hastaların büyük bölümü orta ve yüksek hastalık aktivite düzeyinde idi. Bu bulgular romatoid artritli hastaların tedavi gereksinimlerinin yeterli olarak karşılanmadığını düşündürmektedir.Öğe Management of Psoriatic Arthritis: Turkish League Against Rheumatism (TLAR) Expert Opinions(2018) Nas, Kemal; Kılıç, Erkan; Kocabaş, Hilal; Bodur, Hatice; Ataman, Şebnem; Ayhan, Figen; Çevik, Remzi; Akgül, Özgür; Akıncı, Ayşen; Altay, Zuhal; Çapkın, Erhan; Dağlı, Abdullah Zübeyir; Duruöz, Tuncay; Gürer, Gülcan; Göğüş, Feride; Garip, Yeşim; Kaçar, Cahit; Kamanlı, Ayhan; Kaptanoğlu, Ece; Kaya, Taciser; Özdemirel, Erhan Ali; Özel, Sumru; Sezer, İlhan; Sunar, İsmihan; Yılmaz, GürkanObjectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice.Öğe Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR(2015) Ataman, Şebnem; Sarı Sürmeli, Zühre; Sunar, İsmihan; Özdemirel, Erhan; Akıncı, Ayşen; Bodur, Hatice; Kocabaş, Hilal; Akgül, Özgür; Altan, Lale; Altay, Zuhal; Ayhan, Figen; Birtane, Murat; Soy Buğdaycı, Derya; Çapkıni Erhan; Cerrahoğlu, Lale; Duruöz, Mehmet Tuncay; Günaydın, Rezzan; Günendi, Zafer; Gürer, Gülcan; Bal, Ajda; Kaçar, Cahit; Kaptanoğlu, Ece; Kaya, Taciser; Kotevoğlu, Nurdan; Nas, Kemal; Rezvani, Aylin; Şen, Nesrin; Şendur, Ömer Faruk; Yalçın, PeymanObjectives: This study aims to report Turkish League Against Rheumatisms assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of Interest The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial Disclosure The authors received no financial support for the research and/or authorship of this article.Öğe Turkish League Against Rheumatism (TLAR) Recommendations for the Pharmacological Management of Rheumatoid Arthritis: 2018 Update Under Guidance of Current Recommendations(2018) Ataman, Şebnem; Kocabaş Ecesoy, Hilal; Yılmaz, Gürkan; Bodur, Hatice; Nas, Kemal; Ayhan, Fikriye FigenObjectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining 70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected.Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.Öğe Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial Spondyloarthritis(2018) Bodur, Hatice; Yurdakul, Fatma Gül; Ataman, Şebnem; Garip, Yeşim; Nas, Kemal; Ayhan, Fikriye Figen; Kocabaş, Hilal; Akgül, Özgür; Akıncı, Ayşen; Altay, Zuhal; Birtane, Murat; Soy Budayıcı, Derya; Çapkın, Erhan; Çevik, Remzi; Duruöz, Tuncay; Gürer, Gülcan; Kaçar, Cahit; Kamanlı, Ayhan; Kaptanoğlu, Ece; Kaya, Taciser; Kuru, Ömer; Alkan Melikoğlu, Meltem; Özdemirel, Erhan; Özel, Sumru; Rezvani, Aylin; Sezer, İlhan; Sunar, İsmihan; Yılmaz, GürkanObjectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloarthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation. Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength. Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific evidence. These recommendations will be updated regularly in accordance with current developments.
