EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maya H Buch,Maya H Buch,Gerd R Burmester,Maxime Dougados,Paul Emery,Paul Emery,Cécile Gaujoux-Viala,Laure Gossec,Jackie L Nam,Jackie L Nam,Sofia Ramiro,Kevin L. Winthrop,Maarten de Wit,Daniel Aletaha,Neil Betteridge,Johannes W. J. Bijlsma,Maarten Boers,Frank Buttgereit,Bernard Combe,Maurizio Cutolo,Nemanja Damjanov,Johanna M. W. Hazes,Marios Kouloumas,Tore K Kvien,Xavier Mariette,Karel Pavelka,Piet L. C. M. van Riel,Andrea Rubbert-Roth,Marieke Scholte-Voshaar,David Scott,T. Sokka-Isler,John B. Wong,Désirée van der Heijde +35 more
TLDR
These recommendations intend informing rheumatologists, patients, national rheumology societies, hospital officials, social security agencies and regulators about EULAR's most recent consensus on the management of RA, aimed at attaining best outcomes with current therapies.Abstract:
In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6 months (or improvement not seen atread more
Citations
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Journal ArticleDOI
2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis
Jasvinder A. Singh,Daniel E. Furst,Aseem Bharat,Jeffrey R. Curtis,Arthur Kavanaugh,Joel M. Kremer,Larry W. Moreland,James O'Dell,Kevin L. Winthrop,Timothy Beukelman,S. Louis Bridges,W. Winn Chatham,Harold E. Paulus,Maria E. Suarez-Almazor,Claire Bombardier,Maxime Dougados,Dinesh Khanna,Charles M. King,Amye L. Leong,Eric L. Matteson,John T. Schousboe,Eileen Moynihan,Karen S. Kolba,Archana Jain,Elizabeth R. Volkmann,Harsh Agrawal,Sangmee Bae,Amy S. Mudano,Nivedita M. Patkar,Kenneth G. Saag +29 more
TL;DR: The 2012 ACR RA recommendations were developed by two expert panels: a non-voting working group and Core Expert Panel of clinicians and methodologists responsible for the selection of the relevant topic areas to be considered, the systematic literature review, and the evidence synthesis.
Journal ArticleDOI
2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis
Désirée van der Heijde,Sofia Ramiro,Robert Landewé,Xenofon Baraliakos,Filip Van den Bosch,Alexandre Sepriano,Alexandre Sepriano,Andrea Regel,Adrian Ciurea,Hanne Dagfinrud,Maxime Dougados,Maxime Dougados,Floris A. van Gaalen,Pál Géher,Irene E. van der Horst-Bruinsma,Robert D. Inman,Merryn Jongkees,Uta Kiltz,Tore K Kvien,Pedro Machado,Helena Marzo-Ortega,Anna Molto,Anna Molto,Victoria Navarro-Compán,Salih Ozgocmen,Fernando Pimentel-Santos,John D. Reveille,Martin Rudwaleit,Martin Rudwaleit,J. Sieper,Percival D. Sampaio-Barros,Dieter Wiek,Jürgen Braun +32 more
TL;DR: The 2016 Assessment of SpondyloArthritis international Society-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA and three overarching principles and 13 recommendations deal with surgery and spinal fractures.
Journal ArticleDOI
Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force
Josef S Smolen,Ferdinand C. Breedveld,Gerd R Burmester,Vivian P. Bykerk,Maxime Dougados,Paul Emery,Tore K Kvien,M Victoria Navarro-Compán,Susan Oliver,Monika Schoels,Marieke Scholte-Voshaar,Tanja Stamm,Michaela Stoffer,Tsutomu Takeuchi,Daniel Aletaha,Jose Louis Andreu,Martin Aringer,Martin J. Bergman,Neil Betteridge,H. Bijlsma,Harald Burkhardt,Mario H. Cardiel,Bernard Combe,Patrick Durez,João Eurico Fonseca,A. Gibofsky,Juan J. Gomez-Reino,Winfried Graninger,Pekka Hannonen,Boulos Haraoui,Marios Kouloumas,Robert Landewé,Emilio Martín-Mola,Peter Nash,Mikkel Østergaard,Andrew J. K. Östör,Pam Richards,T. Sokka-Isler,Carter Thorne,Athanasios G. Tzioufas,Ronald F van Vollenhoven,Martinus de Wit,Désirée van der Heijde +42 more
TL;DR: The 4 overarching principles and 10 recommendations are based on stronger evidence than before and are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA.
Journal ArticleDOI
COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options.
Tomasz J. Guzik,Tomasz J. Guzik,Saidi A Mohiddin,Anthony Dimarco,Vimal Patel,K Savvatis,Federica M. Marelli-Berg,Meena S. Madhur,Maciej Tomaszewski,Pasquale Maffia,Pasquale Maffia,Fulvio D'Acquisto,Stuart A. Nicklin,Ali J. Marian,Ryszard Nosalski,Ryszard Nosalski,Eleanor Murray,Bartłomiej Guzik,Colin Berry,Rhian M. Touyz,Reinhold Kreutz,Dao Wen Wang,David Bhella,Orlando Sagliocco,Filippo Crea,E. Thomson,Iain B. McInnes +26 more
TL;DR: While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis, Hence, patients should not discontinue their use.
Journal ArticleDOI
Diagnosis and Management of Rheumatoid Arthritis: A Review.
Daniel Aletaha,Josef S Smolen +1 more
TL;DR: A treat-to-target strategy aimed at reducing disease activity by at least 50% within 3 months and achieving remission or low disease activity within 6 months, with sequential drug treatment if needed, can prevent RA-related disability.
References
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Journal ArticleDOI
Suboptimal management of rheumatoid arthritis in the Middle East and Africa: could the EULAR recommendations be the start of a solution?
Bassel El Zorkany,Humaid A. AlWahshi,Mohamed Hammoudeh,Samar Al Emadi,Romela Benitha,Adel Al Awadhi,Elyes Bouajina,Ahmed Laatar,Samir El Badawy,Marzooq Al Badi,Mustafa Al-Maini,Jamal Al Saleh,Ramiz Alswailem,Mahmood Moosa Tar Mahomed Ally,Wafaa Batha,Hachemi Djoudi,Ayman El Garf,Khaled El Hadidi,Mohamed El Marzouqi,Musa Hadidi,Ajesh B. Maharaj,Abdel Fattah Masri,Ayman Mofti,Ibrahim Nahar,Clive Allan Pettipher,Catherine Elizabeth Spargo,Paul Emery,Paul Emery +27 more
TL;DR: To optimise the management of RA in the Middle East and Africa, will require a multi-pronged approach from a diverse group of stakeholders-including local, national and regional societies, and service providers-to collect data on the epidemiology and burden of the disease.
Journal ArticleDOI
Long-term efficacy and toxicity of ciclosporin A in combination with methotrexate in poor prognosis rheumatoid arthritis
TL;DR: A 24-month open-label, randomised study comparing a methotrexate and ciclosporin A combination with sulfasalazine monotherapy in 82 early, poor-prognosis RA patients to present long-term efficacy and toxicity data.
Journal ArticleDOI
No evidence for association of the KLF12 gene with rheumatoid arthritis in a large UK cohort
Stephen Eyre,Edward Flynn,Paul Martin,Anne Hinks,Anthony G. Wilson,Ann W. Morgan,Paul Emery,Sophia Steer,Lynne J. Hocking,David M. Reid,Pille Harrison,Paul Wordsworth,Wendy Thomson,Jane Worthington,Anne Barton +14 more
TL;DR: A modestly-sized GWAS was undertaken in a Spanish population comprising 400 patients with RA and 400 controls, detecting association with the KLF12 gene, which is a repressor for a transcriptional regulatory factor which has been implicated in the control of inflammation.
Journal ArticleDOI
Early consultation with a rheumatologist for RA: does it reduce subsequent use of orthopaedic surgery?
Debbie Ehrmann Feldman,Sasha Bernatsky,Michelle Houde,Marie-Eve Beauchamp,Michal Abrahamowicz +4 more
TL;DR: In this article, the authors studied persons who had a diagnosis of RA based on billing code data in the province of Quebec in 1995, and for whom the initial date of RA diagnosis by a non-rheumatologist could be established before the confirmatory diagnosis by the rheumatologists.
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