TY - JOUR
T1 - EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs
AU - Smolen, Josef S.
AU - Landewé, Robert
AU - Breedveld, Ferdinand C.
AU - Dougados, Maxime
AU - Emery, Paul
AU - Gaujoux-Viala, Cecile
AU - Gorter, Simone
AU - Knevel, Rachel
AU - Nam, Jackie
AU - Schoels, Monika
AU - Aletaha, Daniel
AU - Buch, Maya
AU - Gossec, Laure
AU - Huizinga, Tom
AU - Bijlsma, Johannes W.J.W.
AU - Burmester, Gerd
AU - Combe, Bernard
AU - Cutolo, Maurizio
AU - Gabay, Cem
AU - Gomez-Reino, Juan
AU - Kouloumas, Marios
AU - Kvien, Tore K.
AU - Martin-Mola, Emilio
AU - McInnes, Iain
AU - Pavelka, Karel
AU - Van Riel, Piet
AU - Scholte, Marieke
AU - Scott, David L.
AU - Sokka, Tuulikki
AU - Valesini, Guido
AU - Van Vollenhoven, Ronald
AU - Winthrop, Kevin L.
AU - Wong, John
AU - Zink, Angela
AU - Van Der Heijde, Désirée
PY - 2010/6
Y1 - 2010/6
N2 - Treatment of rheumatoid arthritis (RA) may differ among rheumatologists and currently, clear and consensual international recommendations on RA treatment are not available. In this paper recommendations for the treatment of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects, are described. The recommendations are based on evidence from five systematic literature reviews (SLRs) performed for synthetic DMARDs, biological DMARDs, GCs, treatment strategies and economic issues. The SLR-derived evidence was discussed and summarised as an expert opinion in the course of a Delphi-like process. Levels of evidence, strength of recommendations and levels of agreement were derived. Fifteen recommendations were developed covering an area from general aspects such as remission/low disease activity as treatment aim via the preference for methotrexate monotherapy with or without GCs vis-à-vis combination of synthetic DMARDs to the use of biological agents mainly in patients for whom synthetic DMARDs and tumour necrosis factor inhibitors had failed. Cost effectiveness of the treatments was additionally examined. These recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA, based on evidence and expert opinion.
AB - Treatment of rheumatoid arthritis (RA) may differ among rheumatologists and currently, clear and consensual international recommendations on RA treatment are not available. In this paper recommendations for the treatment of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects, are described. The recommendations are based on evidence from five systematic literature reviews (SLRs) performed for synthetic DMARDs, biological DMARDs, GCs, treatment strategies and economic issues. The SLR-derived evidence was discussed and summarised as an expert opinion in the course of a Delphi-like process. Levels of evidence, strength of recommendations and levels of agreement were derived. Fifteen recommendations were developed covering an area from general aspects such as remission/low disease activity as treatment aim via the preference for methotrexate monotherapy with or without GCs vis-à-vis combination of synthetic DMARDs to the use of biological agents mainly in patients for whom synthetic DMARDs and tumour necrosis factor inhibitors had failed. Cost effectiveness of the treatments was additionally examined. These recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA, based on evidence and expert opinion.
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U2 - 10.1136/ard.2009.126532
DO - 10.1136/ard.2009.126532
M3 - Article
C2 - 20444750
AN - SCOPUS:77953696525
SN - 0003-4967
VL - 69
SP - 964
EP - 975
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 6
ER -