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    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, Gürkan
    Objectives: 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.
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    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, Peyman
    Objectives: 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.
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    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, Gürkan
    Objectives: 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.