Guidelines for the drug treatment of rheumatoid arthritis

Mota, Lícia Maria Henrique da; Cruz, Bóris Afonso; Brenol, Claiton Viegas; Pereira, Ivânio Alves; Rezende-Fronza, Lucila Stange; Bértolo, Manoel Barros; Freitas, Marcos Rabelo de; Silva, Nílzio Antônio da; Louzada‐Júnior, Paulo; Giorgio, Rina Dalva Neubarth; Lima, Rodrigo Aires Corrêa; Bernardo, Wanderley Marques; Pinheiro, Geraldo da Rocha Castelar

doi:10.1016/s2255-5021(13)70020-8

Cited by 25 publications

(44 citation statements)

References 174 publications

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“…It was noted that, in every patient, treatment should be aimed at reaching a target of remission or low disease activity, as soon as possible and measuring disease activity using objective parameters such as Disease Activity Score (DAS), DAS28 (DAS of 28 joints), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI) . Consequently, this will halt joint damage, prevent disability and improve quality of life .…”

Section: Resultsmentioning

confidence: 99%

“…Most guidelines recommend the use of a validated composite score such as DAS28, SDAI and CDAI for measuring disease activity before starting treatment, and for monitoring disease activity and drug response after starting treatment . In addition, some guidelines recommend using the Health Assessment Questionnaire (HAQ) for evaluating the functional impact of the disease .…”

Section: Resultsmentioning

confidence: 99%

“…Corticosteroids, in combination with DMARDs, are effective in limiting disease progression, and are particularly effective in decreasing inflammation in patients with flares and improving symptom control in those with early disease . However, given the toxicity with long‐term use, it is recommended to taper therapy as symptoms improve and discontinue completely once patients achieve remission …”

Section: Resultsmentioning

confidence: 99%

“…Duration of remission is required for more than 1 year in the Indian 2008 guidelines, 6–12 months in the 2013 Brazilian guidelines and over 6 months in the German 2013 guidelines . The suggested sequence of drug withdrawal is NSAID, corticosteroid, bDMARD and then cDMARD . The reduction in treatment should be performed cautiously, gradually and in a stepwise manner.…”

Section: Resultsmentioning

confidence: 99%

“…The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR‐BHPR) guidelines warn about the frequent association of withdrawal with flare and disease progression . The 2013 Brazilian guidelines describe withdrawal of cDMARD in exceptional situations …”

Section: Resultsmentioning

confidence: 99%

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APLAR rheumatoid arthritis treatment recommendations

et al. 2015

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Aims: Rheumatoid arthritis is a chronic inflammatory condition that affects approximately 1% of the world's population. There are a wide number of guidelines and recommendations available to support the treatment of rheumatoid arthritis; however, the evidence used for these guidelines is predominantly based on studies in Caucasian subjects and may not be relevant for rheumatoid arthritis patients in the Asia-Pacific region. Therefore, the Asia Pacific League of Associations for Rheumatology established a Steering Committee in 2013 to address this issue. Materials and methods:The AGREE II instrument and the ADAPTE Collaboration framework were applied to systematically identify, appraise, synthesize, and adapt international rheumatoid arthritis guidelines for use in the Asia-Pacific region.Results: Forty rheumatoid arthritis treatment recommendations, based on evidence and expert opinion, were drafted and are presented in this report. Conclusion: The Asia Pacific of Associations for Rheumatology rheumatoid arthritis treatment recommendations are intended to serve as a reference for best practice management of rheumatoid arthritis in Asia-Pacific, focusing on local issues to ensure the delivery of basic care for these patients, and to improve their outcomes. In addition, the document will serve as a reference for national rheumatology associations in Asia-Pacific for developing guidelines in their respective countries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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APLAR rheumatoid arthritis treatment recommendations

et al. 2015

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“Official View” on Glucocorticoids in Rheumatoid Arthritis: A Systematic Review of International Guidelines and Consensus Statements

Palmowski

Buttgereit

Dejaco

et al. 2017

Arthritis Care & Research

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Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

López-Olivo

Colmegna

Matusevich

et al. 2020

Arthritis Care & Research

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Objective To evaluate consensus recommendations regarding management of rheumatoid arthritis (RA) in patients with cancer. Methods We searched electronic databases, guideline registries, and relevant web sites for cancer‐specific recommendations on RA management. Reviewers independently selected and appraised the recommendations according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. We identified similarities and discrepancies among recommendations. Results Of 4,077 unique citations, 39 recommendations were identified, of which half described their consensus process. Average scores for the AGREE II domains ranged from 33% to 87%. Cancer risk in RA was addressed in 79% of recommendations, with acknowledgement of increased overall cancer risk. Recommendations did not agree on the safety of using disease‐modifying antirheumatic drugs (DMARDs) in RA patients with cancer, except for the contraindication of tumor necrosis factor inhibitors in patients at risk for lymphoma. Most recommendations agreed that RA treatment should be stopped and re‐evaluated with a new diagnosis of cancer. Recommendations for patients with a history of cancer differed depending on the drug, cancer type, and time since cancer diagnosis. Few recommendations addressed all issues. Conclusion Recommendations for the treatment of RA in patients with cancer often fail to meet expected methodologic criteria. There was agreement on the need for caution when prescribing DMARDs to these patients. However, several areas continue to lack consensus, and given the paucity of evidence, there is an urgent need for research and expert opinion to guide and standardize the management of RA in patients with cancer.

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Guidelines for the drug treatment of rheumatoid arthritis

Cited by 25 publications

References 174 publications

APLAR rheumatoid arthritis treatment recommendations

APLAR rheumatoid arthritis treatment recommendations

“Official View” on Glucocorticoids in Rheumatoid Arthritis: A Systematic Review of International Guidelines and Consensus Statements

Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

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