Intra-articular therapies (IAT) are frequently used to treat joint conditions such as gout, rheumatoid arthritis, or osteoarthritis. The procedure involves inserting a needle into the space between the bones of the joint to deliver medication. The types of injectables used in IAT techniques vary, from steroids to radiopharmaceuticals.
Although IAT is commonly performed, there are variations in how, why, and where it is performed. EULAR aimed to help standardize the way IAT is given and to educate people on what to expect from treatment. An EULAR working group has been set up to develop a set of new recommendations to provide guidance and advice on best practice for IAT.
The working group included doctors, nurses, surgeons and other health professionals, as well as patients. The task force reviewed the evidence on IAT. As there is little published evidence, the task force also conducted two surveys to gather information. The first was sent to patients to get their perspective on what it’s like to have IAT, and the second went to healthcare providers to gather information on how the IAT is. performed in different clinics and settings. After reviewing the evidence, they developed five general principles and eleven individual recommendations.
The principles say that IAT is recommended and widely used in the management of joint disease, and that the technique aims to improve patient-centered outcomes. They also point out that contextual factors are important and contribute to the effect of IAT. As such, IAT should be offered as part of a comprehensive set of individualized information and a shared decision-making process. Finally, they recognize that a variety of healthcare professionals are able to perform these procedures on a routine basis. Individual recommendations cover information on the type of support and advice that people undergoing AID should expect to get from their healthcare team. They also set the minimum for clinic operational procedures, such as making sure IAT is performed in a clean, quiet room, and maintaining good aseptic technique to prevent infections.
EULAR hopes that these new recommendations will be included in different educational programs, used by patient associations and put into practice through scientific societies to help improve consistency and quality of care when performing ATI.
Uson, J., et al. (2021) EULAR recommendations for intra-articular therapies. Annals of Rheumatic Disease. doi.org/10.1136/annrheumdis-2021-220266.