American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease‐modifying antirheumatic drugs in rheumatoid arthritis

Saag, Kenneth G.; Teng, Gim Gee; Patkar, Nivedita M.; Anuntiyo, Jeremy; Finney, Catherine; Curtis, Jeffrey R.; Paulus, Harold E.; Mudano, Amy S.; Pisu, Maria; Elkins-Melton, Mary; Outman, Ryan C.; Allison, Jeroan J.; Almazor, Maria Suarez; Bridges, S. Louis; Chatham, W. Winn; Hochberg, Marc C.; MacLean, Catherine H.; Mikuls, Ted R.; Moreland, Larry W.; O'Dell, James Robert; Turkiewicz, Anthony; Fürst, Daniel E.

doi:10.1002/art.23721

Cited by 1,335 publications

(1,021 citation statements)

References 206 publications

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“…Traditional disease-modifying antirheumatic drugs (DMARDs), most commonly methotrexate (MTX), remain the cornerstone of RA treatment (1)(2)(3). However, traditional DMARD monotherapy frequently fails to adequately control symptoms or disease progression.…”

Section: Introductionmentioning

confidence: 99%

“…However, traditional DMARD monotherapy frequently fails to adequately control symptoms or disease progression. Patients with an inadequate response to traditional DMARDs are often recommended treatment with biologic DMARDs such as tumor necrosis factor (TNF) inhibitors, either as monotherapy or in combination with traditional DMARDs (2). In Japan, 3 TNF inhibitors, infliximab, etanercept, and adalimumab, and 1 anti-interleukin-6 (anti-IL-6) receptor antibody, tocilizumab, are approved for pa-tients with an inadequate response to traditional DMARDs (4 -6).…”

Section: Introductionmentioning

confidence: 99%

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Phase II study of tofacitinib (CP‐690,550) combined with methotrexate in patients with rheumatoid arthritis and an inadequate response to methotrexate

Tanaka

Suzuki

Nakamura

et al. 2011

Arthritis Care & Research

272

224

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Objective. To compare the efficacy, safety, and tolerability of 4 doses of oral tofacitinib (CP-690,550) with placebo in Japanese patients with active rheumatoid arthritis (RA) receiving stable background methotrexate (MTX) who had an inadequate response to MTX alone. Methods. A total of 140 patients were randomized to receive tofacitinib 1, 3, 5, and 10 mg twice a day or placebo in this 12-week, phase II, double-blind study. All patients remained on background MTX. Efficacy and safety were assessed at weeks 1, 2, 4, 8, and 12. The primary efficacy end point was the American College of Rheumatology 20% improvement criteria (ACR20) response rate at week 12.Results. ACR20 response rates at week 12 were significant (P < 0.0001) for all tofacitinib treatment groups: 1 mg twice a day, 64.3%; 3 mg twice a day, 77.8%; 5 mg twice a day, 96.3%; and 10 mg twice a day, 80.8% versus placebo, 14.3%. A significant dose-response relationship for the ACR20 was observed (P < 0.0001). Low disease activity was achieved by 72.7% of patients with high baseline disease activity for tofacitinib 10 mg twice a day at week 12 (P < 0.0001). Significant improvements in the ACR50, ACR70, Health Assessment Questionnaire Disability Index, and Disease Activity Score 28-3 (C-reactive protein) were also reported. The most commonly reported adverse events (AEs) were nasopharyngitis (n ‫؍‬ 13) and increased alanine aminotransferase (n ‫؍‬ 12) and aspartate aminotransferase (n ‫؍‬ 9) levels. These AEs were mild or moderate in severity. Serious AEs were reported by 5 patients. No deaths occurred. Conclusion. In Japanese patients with active RA with an inadequate response to MTX, tofacitinib in combination with MTX over 12 weeks was efficacious and had a manageable safety profile.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phase II study of tofacitinib (CP‐690,550) combined with methotrexate in patients with rheumatoid arthritis and an inadequate response to methotrexate

Tanaka

Suzuki

Nakamura

et al. 2011

Arthritis Care & Research

272

224

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“…Quality has been defined (3)(4)(5), treatment recommendations have been published (6,7), and validated quality measures exist that can inform us as to patient function and level of disease activity (8). A pervasive problem, however, is that the existing electronic health records (EHRs) are not optimized to provide the functionality needed to reliably operationalize care delivery for patients with rheumatic disease.…”

Section: Introductionmentioning

confidence: 99%

Improving the Quality of Care of Patients With Rheumatic Disease Using Patient‐Centric Electronic Redesign Software

Newman

Lerch

Billet

et al. 2015

Arthritis Care & Research

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Objective. Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software. Methods. The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatologyrelated demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception. Results. Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P ‫؍‬ 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted. Conclusion. We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated.

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“…This method has been developed to facilitate preference elicitation in difficult decision-making processes by disentangling a complex situation with a series of simplified scenarios in which choice options can be presented against one another, i.e., by pairs. In comparison to other expert opinion approaches such as the RAND Appropriateness Method used in the 2008 ACR recommendations, in which respondents were asked to rate the appropriateness of a specific option (21,37), the pairwise method does not require any direct or absolute rating (or ranking) of the proposed options, but simply asks respondents to choose between 2 possibilities for each vignette. Response compilation enables the ranking of the different choice options, which expresses respondents' overall preferences for each clinical situation (38).…”

Section: Methodsmentioning

confidence: 99%

“…The European League Against Rheumatism has recommended the introduction of methotrexate (MTX) within the first few months following RA onset because it can allow for significant control of RA inflammatory activity and structural damage, and may subsequently be an anchor for adding another DMARD in case of inadequate response (20). Very recently, the American College of Rheumatology (ACR) published recommendations for the use of nonbiologic and biologic DMARDs in RA patients and proposed therapeutic options for patients with both early and established RA (21). However, making decisions about treatment may be complex and challenging.…”

Section: Introductionmentioning

confidence: 99%

Choice of second‐line disease‐modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: A decision tree for clinical practice based on rheumatologists' preferences

Fautrel¹,

Guillemin²,

Meyer³

et al. 2009

Arthritis & Rheumatism

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Objective. To survey rheumatologists' preferences for the choice of a second-line disease-modifying antirheumatic drug (DMARD) after inadequate response with methotrexate (MTX) therapy in rheumatoid arthritis (RA).Methods. Thirty-six rheumatologists stated their preferences for RA treatment after inadequate response with MTX therapy (optimal dose at least 6 months). From the initial scenario, we derived 54 vignettes varying by rheumatoid factor or anti-cyclic citrullinated peptide antibody presence, swollen joint count, Disease Activity Score in 28 joints, and structural damage. Respondents stated their preference among 5 therapeutic options: MTX continuation, switch to another conventional DMARD, addition of another conventional DMARD, addition of anakinra, or addition of a tumor necrosis factor (TNF) blocker. Presentation by pairs yielded 10 combinations of strategies for each variant, totaling 540 vignettes; participants evaluated a random sample of 180 vignettes. Determinants of each top-ranked option were analyzed by logistic regression. The compilation of these data served to define a therapeutic algorithm. Results. The responses of 33 rheumatologists were analyzable. Therapeutic preferences corresponded to the top-ranked options. For patients with mild or moderately active RA, either a switch or step-up strategy to another conventional DMARD was top ranked. TNF blockers were preferred for RA patients with high disease activity or progressive structural damage. On the basis of these preferences, we developed a simple decision tree for use in daily clinical practice. Conclusion. Our simple, easy-to-use decision tree developed from rheumatologists' preferences for therapy after failure of MTX therapy in RA treatment may guide rheumatologists in daily practice to choose a second-line DMARD.

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American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease‐modifying antirheumatic drugs in rheumatoid arthritis

Abstract: Guidelines and recommendations developed and/or endorsed by the American

Cited by 1,335 publications

References 206 publications

Phase II study of tofacitinib (CP‐690,550) combined with methotrexate in patients with rheumatoid arthritis and an inadequate response to methotrexate

Phase II study of tofacitinib (CP‐690,550) combined with methotrexate in patients with rheumatoid arthritis and an inadequate response to methotrexate

Improving the Quality of Care of Patients With Rheumatic Disease Using Patient‐Centric Electronic Redesign Software

Choice of second‐line disease‐modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: A decision tree for clinical practice based on rheumatologists' preferences

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