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2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases
2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

Objectives: a European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs).

Methods: six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed.

Results: five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations.

Conclusions: these recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.

arthritis, epidemiology, patient reported outcome measures, smoking
0003-4967
48-56
Gwinnutt, James M.
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Wieczorek, Maud
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Balanescu, Andra
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Bischoff-Ferrari, Heike A.
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Boonen, Annelies
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Cavalli, Giulio
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de Souza, Savia
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de Thurah, Annette
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Dorner, Thomas E.
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Moe, Rikke Helene
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Putrik, Polina
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Rodríguez-Carrio, Javier
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Silva-Fernández, Lucía
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Stamm, Tanja
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Walker-Bone, Karen
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Welling, Joep
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Zlatković-Švenda, Mirjana I.
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Guillemin, Francis
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Verstappen, Suzanne M.M.
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Gwinnutt, James M.
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Wieczorek, Maud
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Balanescu, Andra
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Bischoff-Ferrari, Heike A.
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Boonen, Annelies
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Cavalli, Giulio
85f0c380-ae3e-44c5-86a6-c6b47b8e8eb0
de Souza, Savia
ee3dac02-60eb-4921-8e23-56cbc4536836
de Thurah, Annette
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Dorner, Thomas E.
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Moe, Rikke Helene
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Putrik, Polina
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Rodríguez-Carrio, Javier
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Silva-Fernández, Lucía
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Stamm, Tanja
abe85120-cb3d-4b86-8e65-ad91c602445c
Walker-Bone, Karen
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Welling, Joep
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Zlatković-Švenda, Mirjana I.
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Guillemin, Francis
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Verstappen, Suzanne M.M.
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Gwinnutt, James M., Wieczorek, Maud, Balanescu, Andra, Bischoff-Ferrari, Heike A., Boonen, Annelies, Cavalli, Giulio, de Souza, Savia, de Thurah, Annette, Dorner, Thomas E., Moe, Rikke Helene, Putrik, Polina, Rodríguez-Carrio, Javier, Silva-Fernández, Lucía, Stamm, Tanja, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana I., Guillemin, Francis and Verstappen, Suzanne M.M. (2023) 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Annals of the Rheumatic Diseases, 82 (1), 48-56. (doi:10.1136/annrheumdis-2021-222020).

Record type: Article

Abstract

Objectives: a European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs).

Methods: six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed.

Results: five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations.

Conclusions: these recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.

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EULAR TF Lifestyle recommendations manuscript - resubmission clean - Accepted Manuscript
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Accepted/In Press date: 4 February 2022
e-pub ahead of print date: 8 March 2022
Published date: 3 January 2023
Additional Information: Funding Information: SMMV and JMG are supported by Versus Arthritis (21755) and the NIHR Manchester Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. JRC is supported by the Juan de la Cierva (IJCI-2017-32070) and Sara Borrell (CD19/00120) programs. The taskforce would like to thank EULAR for providing financial support for this project.
Keywords: arthritis, epidemiology, patient reported outcome measures, smoking

Identifiers

Local EPrints ID: 456304
URI: http://eprints.soton.ac.uk/id/eprint/456304
ISSN: 0003-4967
PURE UUID: f18500dc-8909-4400-9580-5b1d591fd9d5
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 27 Apr 2022 02:10
Last modified: 17 Mar 2024 07:15

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Contributors

Author: James M. Gwinnutt
Author: Maud Wieczorek
Author: Andra Balanescu
Author: Heike A. Bischoff-Ferrari
Author: Annelies Boonen
Author: Giulio Cavalli
Author: Savia de Souza
Author: Annette de Thurah
Author: Thomas E. Dorner
Author: Rikke Helene Moe
Author: Polina Putrik
Author: Javier Rodríguez-Carrio
Author: Lucía Silva-Fernández
Author: Tanja Stamm
Author: Joep Welling
Author: Mirjana I. Zlatković-Švenda
Author: Francis Guillemin
Author: Suzanne M.M. Verstappen

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