NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

National Collaborating Centre for Chronic Conditions (UK). Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults. London: Royal College of Physicians (UK); 2009 Feb. (NICE Clinical Guidelines, No. 79.)

Cover of Rheumatoid Arthritis

Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults.

Show details

Acronyms, abbreviations and glossary

Acronyms and abbreviations

ABA

Abatacept

ACR

American College of Rheumatology (see ARA)

ACR20, 50, 70

ACR criteria 20, 50, 70

ADA

Adalimumab

ADL

Activities of daily living

AEs

Adverse events

AIMS

Arthritis Impact Measurement Scale

AL-TENS

Acupuncture-like transcutaneous electrical nerve stimulation

Anti-CCP

Anti-cyclic citrullinated peptide

Anti-TNF

Anti-tumor necrosis factor

ARA

American Rheumatism Association (now ACR)

ARMA

Arthritis and Musculoskeletal Alliance

AUC

Area under the curve

ARC

Arthritis Research Campaign

BMI

Body mass index

BSR

British Society of Rheumatology

CBT

Cognitive behavioral therapy

CI

Confidence interval (95% unless stated otherwise)

COX-2

Cyclooxegenase-2

CRP

C-reactive protein

CS

Corticosteroid

CsA

Cyclosporin A

CTX

Cyclophosphamide

CV

Cardio-vascular

DAS (DAS28, DAS32)

Disease Activity Score

DMARD

Disease modifying antirheumatic drug

EA

Electroacupuncture

EQ-5D

EuroQol 5-dimensional outcomes questionnaire

EOW, eow

Every other week

ESR

Erythrocyte sedimentation rate

ETN

Etanercept

EULAR

The European League against Rheumatism

EW, ew

Every week

GDG

Guideline development group

GI

Gastrointestinal

HAQ

Stanford health assessment questionnaire score

HCQ

Hydroxychloroquine

IA

Inflammatory arthritis, or Intra-articular

ICER

Incremental cost-effectiveness ratio

IFX

Infliximab

IM

Intramuscular

IRGL

Impact of Rheumatic Diseases on General Health and Lifestyle Questionnaire

ITT

Intention to treat analysis

IV/iv

Intravenous

JSN

Joint space narrowing

LASER

Light amplification by stimulated emission of radiation

MA

Meta-analysis

MACTAR

McMaster Toronto Arthritis Patient Preference Disability Questionnaire

MCP

Metacarpophalangeal joint

MD

Mean difference

MDT

Multidisciplinary team

MTP

Metatarsophalangeal joint

MTX

Methotrexate

MHRA

Medicines and Healthcare products Regulatory Agency

MI

Myocardial infarction

NCC-CC

National Collaborating Centre for Chronic Conditions

NHS

National Health Service; this guideline is intended for use in the NHS in England and Wales

NICE

National Institute for Health and Clinical Excellence

NS

Not significant (at the 5% level unless stated otherwise)

NSAID

Non-steroidal anti-inflammatory drugs

NRAS

National Rheumatoid Arthritis Society

OMERACT

Outcome Measures in Rheumatoid Arthritis Clinical Trials

OR

Odds ratio

OT

Occupational therapy or therapist

PIP

Proximal interphalangeal joint

PPI

Proton pump inhibitor

PPV

Positive predictive value

PUFA

Polyunsaturated fatty acid

QALY

Quality-adjusted life-year

QoL

Quality of Life

RAI

Ritchie Articular Index

RCT

Randomised controlled trial

RF

Rheumatoid factor

ROM

Range of motion

RR

Relative risk

RTX

Rituximab

SAARD

Slow-acting antirheumatic drugs

SAEs

Serious adverse events

SC/sc

Subcutaneous

SDAI

Simplified Disease Activity Index

SHS

Sharp/van der Heijde Score

SF-12

Short form (12 point) questionnaire

SF-36

Short form (36 point) questionnaire

SMD

Standardised mean difference

SR

Systematic review

SS

Statistically significant

SSZ

Sulphasalazine

TENS

Transcutaneous electrical nerve stimulation

TF

Transdermal fentanyl

TJR

Total joint replacement

TSS

Total Sharp Score

UA

Undifferentiated arthritis

UPA

Undifferentiated polyarthritis

VAS

Visual analogue scale

WMD

Weighted mean differences

Glossary

Biological drug/biologic

Type of DMARD which targets pro-inflammatory cytokines that are involved in joint destruction (particularly TNF-alpha and IL-1).

Clinically significant improvement

Some trials define a dichotomous outcome of clinically significant pain relief as having been achieved above a specific threshold on a pain score, e.g. pain VAS. However, there is no standard threshold and each such trial should be considered individually.

Cohort study

A retrospective or prospective follow-up study. Groups of individuals to be followed up are defined on the basis of presence or absence of exposure to a suspected risk factor or intervention. cohort study can be comparative, in which case two or more groups are selected on the basis of differences in their exposure to the agent of interest.

Confidence interval

A range of values which contain the true value for the population with a stated ‘confidence’ (conventionally 95%). The interval is calculated from sample data, and generally straddles the sample estimate. The 95% confidence value means that if the study, and the method used to calculate the interval, is repeated many times, then 95% of the calculated intervals will actually contain the true value for the whole population.

Cochrane review

The Cochrane Library consists of a regularly updated collection of evidence-based medicine databases including the Cochrane Database of Systematic Reviews (reviews of randomised controlled trials prepared by the Cochrane Collaboration).

Cost-consequence analysis

A type of economic evaluation where, for each intervention, various health outcomes are reported in addition to cost, but there is no overall measure of health gain.

Cost-effectiveness analysis

An economic study design in which consequences of different interventions are measured using a single outcome, usually in natural units (for example, life-years gained, deaths avoided, heart attacks avoided, cases detected). Alternative interventions are then compared in terms of cost per unit of effectiveness.

Cost-utility analysis

A form of cost-effectiveness analysis in which the units of effectiveness are quality adjusted life-years (QALYs).

Disease modifying antirheumatic drug

Treatment that can reduce or prevent joint damage.

Established RA

Rheumatoid arthritis disease duration of longer than two years.

Incremental cost

The cost of one alternative less the cost of another.

Incremental cost effectiveness ratio

The ratio of the difference in costs between two alternatives to the difference in effectiveness between the same two alternatives.

Larsen Score

Method of assessing radiographic joint damage cause by RA.

Manual therapy

A range of physiotherapy techniques where the affected joint (typically the hip) is manipulated and stretched beyond the range of motion that the person with osteoarthritis is able to use.

Meta-analysis

A statistical technique for combining (pooling) the results of a number of studies that address the same question and report on the same outcomes to produce a summary result.

Methodological limitations

Features of the design or reporting of a clinical study which are known to be associated with risk of bias or lack of validity. Where a study is reported in this guideline as having significant methodological limitations, a recommendation has not been directly derived from it.

Multivariate

Analysis of more than one variable at a time. Takes into account the effects of all variables on the response of interest.

Observational study

Retrospective or prospective study in which the investigator observes the natural course of events with or without control groups, for example cohort studies and case-control studies.

Odds ratio

A measure of treatment effectiveness: the odds of an event happening in the intervention group, divided by the odds of it happening in the control group. The ‘odds’ is the ratio of non-events to events.

p values

The probability that an observed difference could have occurred by chance. A p value of less than 0.05 is conventionally considered to be ‘statistically significant’.

Quality of life

Refers to the level of comfort, enjoyment and ability to pursue daily activities.

Quality-adjusted life-year

A measure of health outcome which assigns to each period of time a weight, ranging from 0 to 1, corresponding to the health-related quality of life during that period, where a weight of 1 corresponds to optimal health, and a weight of 0 corresponds to a health state judged equivalent to death; these are then aggregated across time periods.

Randomised controlled trial

A trial in which people are randomly assigned to two (or more) groups: one (the experimental group) receiving the treatment that is being tested, and the other (the comparison or control group) receiving an alternative treatment, a placebo (dummy treatment) or no treatment. The two groups are followed up to compare differences in outcomes to see how effective the experimental treatment was. Such trial designs help minimize experimental bias.

Recent-onset RA

Rheumatoid arthritis disease duration of up to two years. Within recent-onset RA, categories of suspected persistent synovitis or suspected RA refer to patients in whom a diagnosis is not yet clear, but in whom referral to specialist care or further investigation is required.

Rescue medication

In this guideline, this is an outcome recorded by some studies. The rate of rescue medication use is the rate at which participants had to use a stronger medication (typically for analgesia).

Self-management

A term used for aspects of RA care which a person can do for themselves with advice from the primary care team, eg GP, nurse, physiotherapist, occupational therapist and information leaflets.

Sensitivity analysis

A measure of the extent to which small changes in parameters and variables affect a result calculated from them. In this guideline, sensitivity analysis is used in health economic modelling.

Stakeholder

Any national organisation, including patient and carer groups, healthcare professionals and commercial companies with an interest in the guideline under development.

Statistical significance

A result is deemed statistically significant if the probability of the result occurring by chance is less than 1 in 20 (p <0.05).

Systematic review

Research that summarises the evidence on a clearly formulated question according to a pre-defined protocol using systematic and explicit methods to identify, select and appraise relevant studies, and to extract, collate and report their findings. It may or may not use statistical meta-analysis.

Technology appraisal

Formal ascertainment and review of the evidence surrounding a health technology, restricted in the current document to appraisals undertaken by NICE.

Univariate

Analysis which separately explores each variable in a data set.

Utility

A number between 0 and 1 that can be assigned to a particular state of health, assessing the holistic impact on quality of life and allowing states to be ranked in order of (average) patient preference.

Copyright © 2009, Royal College of Physicians of London.

All rights reserved. No part of this publication may be reproduced in any form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher.

Bookshelf ID: NBK51929

Views

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...