Update of the Consensus Statement of the Spanish Society of Rheumatology on the management of biologic therapies in rheumatoid arthritis

Molina, Jesús Tornero; Sala, Raimón Sanmartí; Valverde, Vicente Rodríguez; Mola, Emilio Martín; Fuente, José Luís Marenco de la; Álvaro, Isidoro González; Fernández, Santiago Muñoz; Carnota, Juan Gómez-Reino; Pérez, Luis C. Velázquez; Gualda, Enrique Batllé; Criado, Alejandro; Andreu, José Luís; Álvaro‐Gracia, José María; López, Juan Antonio Martínez; Santamaría, Estibaliz Loza

doi:10.1016/s2173-5743(10)70006-x

Cited by 18 publications

(10 citation statements)

References 89 publications

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“…A total of 16,064 unique abstracts were reviewed and 808 articles were subjected to a full‐text review. A total of 10 RA guidelines () and 3 RA QI sets (4 indicators) () met inclusion criteria (Figure ). Only 7 general population guidelines discussed CV risk in RA () and none of the general population QIs specified RA patients in the numerator or denominator (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Only 7 general population guidelines discussed CV risk in RA () and none of the general population QIs specified RA patients in the numerator or denominator (Figure ). Of the included RA guidelines, only 1 was dedicated entirely to CV risk reduction in RA patients (The European League Against Rheumatism [EULAR] guidelines ) and a further 9 addressed CV prevention in addition to other RA treatment recommendations (). Of the excluded RA guidelines, 27 made no recommendation about CV preventive care, 8 were published before 2008, and a further 11 did not meet the AGREE II criteria ().…”

Section: Resultsmentioning

confidence: 99%

“…All included guidelines covering general treatment recommendations for RA () recommended an early and targeted approach to therapy to control disease activity and reduce functional disability, with the goal of improving RA outcomes. Only the EULAR guidelines formally recommended control of disease activity as a potential means of reducing CVD risk in RA ().…”

Section: Resultsmentioning

confidence: 99%

“…Four guidelines discussed the CV safety of anti‐TNF agents (), and all recommended avoiding their use in patients with New York Heart Association class III or IV heart failure. The BSR 2010 () guidelines also reviewed the evidence for MI and other CV events in relation to anti‐TNF use, but no formal recommendations were made.…”

Section: Resultsmentioning

confidence: 99%

“…This study represents the first systematic review of guidelines and QIs for CV care and prevention of CVD in patients with RA. While only 1 identified guideline was entirely dedicated to CVD prevention (), an additional 9 guidelines covered varied aspects of CV care in RA (). Of the identified general population guidelines, 7 () identified patients with RA as having increased CV risk but made very few RA‐specific recommendations.…”

Section: Discussionmentioning

confidence: 99%

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Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Barber

Smith

Esdaile

et al. 2015

Arthritis Care & Research

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Objective. Cardiovascular disease (CVD) is a leading cause of mortality in rheumatoid arthritis (RA). This study systematically reviewed and appraised guidelines and quality indicators (QIs) pertaining to CVD risk management in patients with RA. Methods. Four electronic medical databases (Medline, Embase, CINAHL, and Web of Science) and gray literature publications were searched using terms and keywords pertaining to guidelines, QIs, RA, and CVD (RA and general population literature searched). Abstracts were screened for inclusion and rated using the Appraisal of Guidelines for Research and Evaluation II instrument independently by 2 of 3 reviewers. Results. In total, 16,064 abstracts were screened and 808 underwent full-text review. A total of 17 guidelines and 3 QI sets published between 2008 and 2013 were included. A number of consistent themes emerged, including the increased CV risk faced by RA patients and the need to address modifiable risk factors on a regular basis. The role of the multidisciplinary team in risk optimization was also highlighted. Ten guidelines provided recommendations for CVD prevention in patients with RA. Unfortunately, most recommendations lacked the specificity required to determine adherence to the recommendation. Only 4 RA-specific CVD QIs were identified (1 general comorbidity screening, formal CVD risk estimation, exercise, and minimizing steroid use). Conclusion. Regular screening for CVD risk factors is an important part of care in patients with RA. Unfortunately, existing RA-specific CVD QIs do not adequately address risk factor management, and existing guideline recommendations lack specificity for measurement and use in quality improvement initiatives.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Barber

Smith

Esdaile

et al. 2015

Arthritis Care & Research

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Dose modifications of anti-TNF drugs in rheumatoid arthritis patients under real-world settings: a systematic review

Ferriols-Lisart

2015

Rheumatol Int

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Anti-TNF dose modifications in rheumatoid arthritis have implications on healthcare resource utilization. The objective was to systematically review the dose modifications, both escalations and reductions, of currently available anti-TNF drugs (adalimumab, certolizumab, etanercept, golimumab and infliximab) in the real-world setting. We performed a systematic literature search of MEDLINE, ISI Web of Science, EMBASE, Indice Médico Español databases and American College of Rheumatology and European League Against Rheumatism annual congresses databases. PRISMA and MOOSE guidelines were followed. Only observational studies were included. Clinical trials were excluded since they do not reflect routine clinical practice. Dose escalations and reductions of the anti-TNF drug and their magnitude were collected. Thirty-four studies fulfill the inclusion criteria. Etanercept was associated with the lower percentage of patients under dose escalation (4.5 %; range 0-22 %), both in naïve (4.9 %) and non-naïve patients (1.3 %). Adalimumab and infliximab were associated with significantly higher percentages. Dose modification magnitude in those patients compared to basal dose was significantly different between treatments; 7.1 % (95 % CI 6.3-7.9 %) in etanercept, 30.4 % (95 % CI 28.3-32.5 %) in adalimumab and 21 % (95 % CI 20.3-21.7 %) in infliximab. Adalimumab and infliximab were associated with a higher risk of dose escalation relative to etanercept. There were no significant differences in the dose reduction percentages for the whole group of patients between treatments. In rheumatoid arthritis, etanercept is associated with a significantly lower percentage of dose-escalated patients and a lower magnitude of dose modification. Significant differences in the dose reduction between anti-TNF drugs evaluated were not observed.

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How elderly rheumatoid arthritis patients respond at one year of treatment with certolizumab pegol

et al. 2018

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Update of the Consensus Statement of the Spanish Society of Rheumatology on the management of biologic therapies in rheumatoid arthritis

Cited by 18 publications

References 89 publications

Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Dose modifications of anti-TNF drugs in rheumatoid arthritis patients under real-world settings: a systematic review

How elderly rheumatoid arthritis patients respond at one year of treatment with certolizumab pegol

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