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Objectives: 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.

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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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Progressive pseudorheumatoid dysplasia is a rare hereditary skeletal disease characterized by bone and cartilage dysplasia, progressive arthropathy without sign of systemic or synovial inflammation. Relapsing polychondritis (RP) is a rare autoimmune disease associated with inflammation in cartilaginous and other proteoglycan rich structures. An associated autoimmune and/or hematologic disorder is seen in over 30% of patients with RP. To our knowledge, coexistence of progressive pseudorheumatoid dysplasia and RP has not been previously reported. In this article, we describe an unusual case of coexisting progressive pseudorheumatoid dysplasia with RP. Physicians should be aware of this possible association

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Amaç: Bu çalışmada Türkiye'de romatizmal hastalıkların tedavisinde kullanılan biyolojik ajanlara bağlı gelişen bildirilmiş yan etkiler derlendi.Hastalar ve yöntemler: Ocak 2000 ile Ocak 2012 tarihleri arasında romatizmal hastalıkların tedavisinde kullanılan infliksimab, etanersept, adalimumab, anakinra, rituksimab dahil olmak üzere biyolojik ajanlara bağlı gelişen yan etkileri bildiren olgu ve olgu serileri MedLine, Web of Science ve Scopus veri tabanları kullanılarak İngilizce ve Türkçe dillerinde tarandı.Bulgular: Literatürde Türkiye'den biyolojik ajana bağlı yan etki görülen romatizmal hastalıklı toplam 53 olgu (21 erkek, 32 kadın) bildirilmiştir. Yaş ortalaması 39.0±15.6 yıl ve ortalama hastalık süresi 10.6±8.2 yıl idi. Biyolojik ajanlara başlanması ile yan etkinin ortaya çıkması arasındaki geçen süre ortalama 8.8±9.2 aydı. Biyolojik ajan kullanımına bağlı olarak en sık görülen yan etki ankilozan spondilit (AS) ve romatoid artrit (RA) hastalarında gözlendi. En sık bildirilen yan etki 14 hastada (%26.4) tüberküloz idi. Diğer yan etkiler psöriyazis (%15.1), solid tümör (%7.6), lenfoma (%5.7), ilaca bağlı lupus (%3.8) ve menstrüel kanama (%3.8) idi. Yan etki gelişen olguların toplam %77.4'ünde biyolojik tedaviler sonlandırıldı.Sonuç: Biyolojik ajanlar nispeten güvenli olmakla beraber, nadiren ciddi yan etkilere neden olabilir. Türkiye'de tüberküloz orta derecede endemik bir hastalık olması nedeniyle, biyolojik ajan tedavisi (özellikle anti-TNF ve abatasept) planlanan hastalar tedavi öncesinde ve tedaviye başladıktan sonra tedavinin olası riskleri açısından bilgilendirilmeli ve yakından takip edilmelidir