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Rheumatoid Arthritis HELP
Based on 31,534 articles published since 2007
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These are the 31534 published articles about Arthritis, Rheumatoid that originated from Worldwide during 2007-2018.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, Minnesota. · Louisiana State University, New Orleans. · University of Pennsylvania, Philadelphia. · University of Michigan, Ann Arbor. · Columbia University, New York, New York. · Albert Einstein College of Medicine, Bronx, New York. · Kaiser Permanente, Fontana, California. · Cleveland Clinic, Cleveland, Ohio. · Midwest Orthopaedics at Rush, Chicago, Illinois. · University of Texas Medical Branch, Galveston. · American College of Rheumatology, Atlanta, Georgia. · Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · University of Utah, Salt Lake City. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Rockefeller University, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · National Data Bank for Rheumatic Diseases, Wichita, Kansas, and University of Nebraska Medical Center, Omaha. · University of Nebraska Medical Center, Omaha. · Dearborn-Sah Institute for Joint Restoration, Fremont, California. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28620948.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

2 Guideline Recommendations for infectious disease screening in migrants to Western Europe with inflammatory arthropathies before starting biologic agents. Results from a multidisciplinary task force of four European societies (SIR, SER, SIMET, SEMTSI) facing the largest impact of the flow of migrants today. 2017

Bartalesi, Filippo / Scirè, Carlo / Requena-Méndez, Ana / Abad, Miguel Angel / Buonfrate, Dora / Caporali, Roberto / Conti, Fabrizio / Diaz-Gonzalez, Federico / Fernández-Espartero, Cruz / Martinez-Fernandez, Carmen / Mascarello, Marta / Generali, Elena / Minisola, Giovanni / Morrone, Aldo / Muñoz, José / Richi, Patricia / Sakellariou, Gariffalia / Salas Coronas, Joaquin / Spinicci, Michele / Castelli, Francesco / Bartoloni, Alessandro / Bisoffi, Zeno / Gimenez-Sanchez, Francisco / Muñoz-Fernandez, Santiago / Matucci-Cerinic, Marco. ·SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy. · Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Epidemiology Unit, Italian Society for Rheumatology, Milano, Italy. · Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clínic, Universitat de Barcelona, Spain. · Division of Rheumatology, Hospital Virgen del Puerto, Plasencia, Spain. · Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy. · Division of Rheumatology, University of Pavia, IRCCS S. Matteo Foundation, Pavia, Italy. · Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University, Rome, Italy. · Department of Medicine, Universidad de La Laguna, Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain. · Servicio de Reumatologia, Hospital Universitario de Mostoles, Madrid, Spain. · Research Unit, Spanish Society of Rheumatology, Madrid, Spain. · Infectious Diseases Unit, University Hospital of Trieste, Italy. · Division of Rheumatology, San Camillo Hospital, Rome, Italy. · General Directorate, San Camillo Hospital, Rome, Italy. · Division of Rheumatology, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Spain. · University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Italy. · Unidad de Vacunación Internacional, Instituto Hispalense de Pediatría, Granada; and Spanish Society of Tropical Medicine and International Health, Spain. · Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, Italy. marco.matuccicerinic@unifi.it. ·Clin Exp Rheumatol · Pubmed #28516869.

ABSTRACT: OBJECTIVES: Inflammatory arthritis needs infectious disease screening before starting a biologic agent, however, few data are known about migrant patients, who represent a peculiar population which requires a multidisciplinary approach among international health specialists and should also be considered by health authorities. For this reason, the Italian and Spanish Societies of Rheumatology (SIR and SER) and Tropical Medicine (SIMET and SEMTSI) promoted a multidisciplinary task force in order to produce specific recommendations about screening and advices to be considered in migrant patients with inflammatory arthritis candidate to receive biological therapy, according to their geographical origin. METHODS: The experts provided a prioritised list of research questions and the eligible spectrum of inflammatory arthritis, biologic drugs and infectious disease were defined in order to perform a systematic literature review. A search was made in Medline, Embase and Cochrane library, updated to March 2015. Ubiquitous infections and HBV, HCV, HIV and tuberculosis that are already considered in national and international recommendations, were not included. The strength of each recommendation was determined. RESULTS: The task force members agreed on 7 overarching principles. The risk of reactivation of selected potentially latent infectious disease was addressed in migrants with inflammatory arthritis candidates for biologics was considered and 15 potentially relevant infections were identified. CONCLUSIONS: Fifteen disease-specific recommendations were formulated on the basis of high level of agreement among the experts panel.

3 Guideline Using a modified Delphi process to establish clinical consensus for the diagnosis, risk assessment and abatacept treatment in patients with aggressive rheumatoid arthritis. 2017

Caporali, Roberto / Carletto, Antonio / Conti, Fabrizio / D'Angelo, Salvatore / Foti, Rosario / Gremese, Elisa / Govoni, Marcello / Iannone, Florenzo / Pellerito, Raffaele / Sinigaglia, Luigi. ·Rheumatology, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy. roberto.caporali@unipv.it. · Rheumatology Unit, University of Verona, Italy. · Rheumatology, Department of Internal Medicine, University "La Sapienza", Rome, Italy. · Rheumatology Department, S. Carlo Hospital, Potenza, Italy. · Rheumatology Unit, Vittorio Emanuele Hospital, Catania, Italy. · Rheumatology Unit, Catholic University of the Sacred Heart, Rome, Italy. · Rheumatology Department, S. Anna University, Ferrara, Italy. · Rheumatology, University of Bari, Italy. · Rheumatology Unit, Ospedale Mauriziano, Turin, Italy. · Rheumatology Department, University of Milan, Italy. ·Clin Exp Rheumatol · Pubmed #28281459.

ABSTRACT: OBJECTIVES: We aimed to formulate consensus statements for the identification of patients with rheumatoid arthritis (RA) who may benefit most from abatacept treatment, in order to clear up points related to its use in rheumatology. METHODS: Two rounds of a modified Delphi process were conducted. In the first round, a board of experts defined a list of consensus statements based on data derived from a non-systematic review on the use of abatacept in adult RA patients. In the second round, clinicians with extensive experience in the treatment of RA were invited to express individually agreement on the statements, using a dedicated online platform. A face-to-face meeting of the board was held after round two. Consensus was defined as 75% agreement. RESULTS: In Delphi process round one, a board of 10 experts defined a list of 20 consensus statements on abatacept treatment. Then, a panel of 37 rheumatologists participated in round two. The majority of clinicians (75.7%) had 10 or more years of experience in the treatment of RA patients. Fifteen of the 20 statements reached the defined level of consensus. CONCLUSIONS: Identified consensus statements may help clinicians to apply to routine-care settings results from clinical studies and clinical recommendations, providing a guide for the initiation of abatacept treatment in RA patients.

4 Guideline Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren's syndrome. 2017

Fisher, Benjamin A / Jonsson, Roland / Daniels, Troy / Bombardieri, Michele / Brown, Rachel M / Morgan, Peter / Bombardieri, Stefano / Ng, Wan-Fai / Tzioufas, Athanasios G / Vitali, Claudio / Shirlaw, Pepe / Haacke, Erlin / Costa, Sebastian / Bootsma, Hendrika / Devauchelle-Pensec, Valerie / Radstake, Timothy R / Mariette, Xavier / Richards, Andrea / Stack, Rebecca / Bowman, Simon J / Barone, Francesca / Anonymous3761007. ·Rheumatology Research Group and Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), University of Birmingham, Birmingham, UK. · Department of Rheumatology, University Hospitals Birmingham NHS Trust, Birmingham, UK. · Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway. · Department of Rheumatology, Haukeland University Hospital, Bergen, Norway. · Department of Orofacial Sciences, University of California San Francisco, San Francisco California, USA. · Centre for Experimental Medicine and Rheumatology, Queen Mary University of London, London, UK. · Department of Pathology, University Hospitals Birmingham NHS Trust, Birmingham, UK. · Department of Pathology, King's College London, London, UK. · Rheumatology Unit, University of Pisa, Pisa, Italy. · Musculoskeletal Research Group and NIHR Biomedical Research Centre in Ageing and Chronic Diseases, Newcastle University, Newcastle, UK. · Department of Pathophysiology, University of Athens, Athens, Greece. · Section of Rheumatology, Casa di Cura di Lecco, Lecco, Italy. · Department of Oral Medicine, King's College London, London, UK. · Department of Pathology, University of Groningen, Groningen, The Netherlands. · Department of Pathology, Brest University Hospital, Brest, France. · Department of Rheumatology and Clinical Immunology, University of Groningen, Groningen, The Netherlands. · Rheumatology Department, Cavale Blanche Hospital and Brest Occidentale University, ER129, Brest, France. · Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. · Rheumatology Department, Université Paris-Sud, Assistance Publique-Hôpitaux de Paris, INSERM U1184, Le Kremlin-Bicêtre, France. · Department of Oral Medicine, Dental Hospital, Birmingham, UK. ·Ann Rheum Dis · Pubmed #27965259.

ABSTRACT: Labial salivary gland (LSG) biopsy is used in the classification of primary Sjögren's syndrome (PSS) and in patient stratification in clinical trials. It may also function as a biomarker. The acquisition of tissue and histological interpretation is variable and needs to be standardised for use in clinical trials. A modified European League Against Rheumatism consensus guideline development strategy was used. The steering committee of the ad hoc working group identified key outstanding points of variability in LSG acquisition and analysis. A 2-day workshop was held to develop consensus where possible and identify points where further discussion/data was needed. These points were reviewed by a subgroup of experts on PSS histopathology and then circulated via an online survey to 50 stakeholder experts consisting of rheumatologists, histopathologists and oral medicine specialists, to assess level of agreement (0-10 scale) and comments. Criteria for agreement were a mean score ≥6/10 and 75% of respondents scoring ≥6/10. Thirty-nine (78%) experts responded and 16 points met criteria for agreement. These points are focused on tissue requirements, identification of the characteristic focal lymphocytic sialadenitis, calculation of the focus score, identification of germinal centres, assessment of the area of leucocyte infiltration, reporting standards and use of prestudy samples for clinical trials. We provide standardised consensus guidance for the use of labial salivary gland histopathology in the classification of PSS and in clinical trials and identify areas where further research is required to achieve evidence-based consensus.

5 Guideline Recommendations by the Spanish Society of Rheumatology for the management of patients diagnosed with rheumatoid arthritis who cannot be treated with methotrexate. 2017

García-Vicuña, Rosario / Martín-Martínez, María Auxiliadora / Gonzalez-Crespo, María Rosa / Tornero-Molina, Jesús / Fernández-Nebro, Antonio / Blanco-García, Francisco Javier / Blanco-Alonso, Ricardo / Marsal-Barril, Sara / Anonymous751064. ·Servicio de Reumatología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Servicio de Reumatología, Hospital 12 de Octubre, Madrid, España. · Servicio de Reumatología, Hospital Universitario de Guadalajara, Guadalajara, España. · Servicio de Reumatología, Hospital Universitario Regional de Málaga, Málaga, España. · Servicio de Reumatología, Complejo Hospitalario A Coruña, A Coruña, España. · Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, España. · Servicio de Reumatología, Hospital Universitario Vall d'Hebron, Barcelona, España. Electronic address: smarsal@grr.pcb.ub.cat. ·Reumatol Clin · Pubmed #27825791.

ABSTRACT: To establish a set of recommendations for the management of patients diagnosed with rheumatoid arthritis (RA) who cannot be treated with methotrexate (MTX) due to contraindications, drug toxicity or lack of adherence, and to establish therapeutic strategies more effective and safer in these RA patients. A qualitative analysis of the scientific evidence available to June 2015. The 2-round Delphi technique of consensus was used to collect and establish expert opinion based on the participants' clinical experience when only low quality evidence was available. A total of eighteen recommendations were developed for the management of this patient profile. Fourteen of these recommendations were related to drug safety aspects. Recommendations on contraindication and toxicity of MTX have been updated. The experts recommend the use of biological monotherapy, a preferred treatment option, in patients whose profiles reveal a contraindication, intolerance or circumstances that prevent us against the use of MTX. There is some high-quality scientific evidence that supports contraindication and establishes certain conditions of MTX use in RA patients with specific clinical profiles.

6 Guideline EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. 2017

Agca, R / Heslinga, S C / Rollefstad, S / Heslinga, M / McInnes, I B / Peters, M J L / Kvien, T K / Dougados, M / Radner, H / Atzeni, F / Primdahl, J / Södergren, A / Wallberg Jonsson, S / van Rompay, J / Zabalan, C / Pedersen, T R / Jacobsson, L / de Vlam, K / Gonzalez-Gay, M A / Semb, A G / Kitas, G D / Smulders, Y M / Szekanecz, Z / Sattar, N / Symmons, D P M / Nurmohamed, M T. ·Departments of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Oslo, Norway. · College of Medical, Veterinary and Life Sciences, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Internal and Vascular Medicine, VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Rheumatology, Paris Descartes University, Hôpital Cochin. Assistance Publique, Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France. · Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria. · IRCCS Galeazzi Orthopedic Institute, Milan, Italy. · Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark. · Sygehus Sønderjylland (Hospital of Southern Jutland), Aabenraa, Denmark. · King Christian 10's Hospital for Rheumatic Diseases, Graasten, Denmark. · Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, Umeå, Sweden. · PARE (patient research partners), Sint-Joris-Weert, Belgium. · Romanian League Against Rheumatism (Vice-President) and Board Member (General Secretary) of AGORA, the Platform of S-E organisations for patients with RMDs, Bucharest, Romania. · Oslo University Hospital, Ullevål, Center for Preventive Medicine and Medical Faculty, University of Oslo, Oslo, Norway. · Department of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg and Section of Rheumatology, Lund, Sweden. · Department of Clinical Sciences Malmö, Lund University, Lund, Sweden. · Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · University of Cantabria, IDIVAL, Santander, Spain. · Head of Research and Development, Academic Affairs Dudley Group NHS Foundation Trust, Arthritis Research UK Centre for Epidemiology, University of Manchester, Russells Hall Hospital, Clinical Research Unit, Dudley, UK. · Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary. · Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK. · Department of Rheumatology and Musculoskeletal Epidemiology, Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK. · Department of Rheumatology Reade, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #27697765.

ABSTRACT: Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.

7 Guideline Treatment Guidelines for Rheumatologic Manifestations of Sjögren's Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain. 2017

Carsons, Steven E / Vivino, Frederick B / Parke, Ann / Carteron, Nancy / Sankar, Vidya / Brasington, Richard / Brennan, Michael T / Ehlers, William / Fox, Robert / Scofield, Hal / Hammitt, Katherine M / Birnbaum, Julius / Kassan, Stuart / Mandel, Steven. ·Winthrop-University Hospital Campus, State University of New York, Stony Brook, Mineola. · University of Pennsylvania, Philadelphia. · University of Connecticut Health Center, Farmington. · University of California at San Francisco. · University of Texas San Antonio Dental School, San Antonio. · Washington University, St. Louis, Missouri. · Carolinas Medical Center, Charlotte, North Carolina. · Scripps Memorial Hospital Xi-Med, La Jolla, California. · University of Oklahoma Health Sciences Center, Oklahoma Medical Research Foundation, and Oklahoma City Department of Veterans Affairs Medical Center, Oklahoma City. · Sjögren's Syndrome Foundation, Bethesda, Maryland. · Johns Hopkins University, Baltimore, Maryland. · University of Colorado, Denver. · Lenox Hill Hospital, New York, and Hofstra Northwell School of Medicine, Hempstead, New York. ·Arthritis Care Res (Hoboken) · Pubmed #27390247.

ABSTRACT: OBJECTIVE: The Sjögren's Syndrome Foundation clinical practice guidelines (CPGs) are designed to improve quality and consistency of care in Sjögren's syndrome by offering recommendations for management. METHODS: Management questions for the systemic manifestations of Sjögren's syndrome were posed by the CPG committee with input from patients and rheumatologists. Clinical questions were assigned to a topic review group that performed systematic reviews and data extraction and drafted guidelines. Quality of evidence and strength of recommendation were rated using the American Society of Clinical Oncology's modification of the Grading of Recommendations Assessment, Development, and Evaluation. Guideline recommendations were reviewed by a consensus expert panel (CEP) composed of 30-40 clinicians from academia and community practices, as well as registered nurses and patients, using a modified Delphi process. A CEP agreement level of 75% was set as a minimum for adoption of a guideline recommendation. RESULTS: Consensus was achieved for 19 recommendations; for 11 additional modules, available data were insufficient to allow a recommendation to be formulated. Of the 19 recommendations, 15 required 1 Delphi round, 2 required 2 rounds, and 2 required 3 rounds. CONCLUSION: Key recommendations include a decision tree for the use of oral disease-modifying antirheumatic drugs for inflammatory musculoskeletal pain, use of self-care measures and advice regarding exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness and for certain extraglandular manifestations, including vasculitis, severe parotid swelling, inflammatory arthritis, pulmonary disease, and mononeuritis multiplex. The CPG committee strongly discouraged the use of tumor necrosis factor inhibitors for sicca symptoms and for the majority of clinical contexts in primary Sjögren's syndrome.

8 Guideline Clinical practice guidelines for oral management of Sjögren disease: Dental caries prevention. 2016

Zero, Domenick T / Brennan, Michael T / Daniels, Troy E / Papas, Athena / Stewart, Carol / Pinto, Andres / Al-Hashimi, Ibtisam / Navazesh, Mahvash / Rhodus, Nelson / Sciubba, James / Singh, Mabi / Wu, Ava J / Frantsve-Hawley, Julie / Tracy, Sharon / Fox, Philip C / Ford, Theresa Lawrence / Cohen, Stephen / Vivino, Frederick B / Hammitt, Katherine M / Anonymous510855. · ·J Am Dent Assoc · Pubmed #26762707.

ABSTRACT: BACKGROUND: Salivary dysfunction in Sjögren disease can lead to serious and costly oral health complications. Clinical practice guidelines for caries prevention in Sjögren disease were developed to improve quality and consistency of care. METHODS: A national panel of experts devised clinical questions in a Population, Intervention, Comparison, Outcomes format and included use of fluoride, salivary stimulants, antimicrobial agents, and nonfluoride remineralizing agents. The panel conducted a systematic search of the literature according to pre-established parameters. At least 2 members extracted the data, and the panel rated the strength of the recommendations by using a variation of grading of recommendations, assessment, development, and evaluation. After a Delphi consensus panel was conducted, the experts finalized the recommendations, with a minimum of 75% agreement required. RESULTS: Final recommendations for patients with Sjögren disease with dry mouth were as follows: topical fluoride should be used in all patients (strong); although no study results link improved salivary flow to caries prevention, the oral health community generally accepts that increasing saliva may contribute to decreased caries incidence, so increasing saliva through gustatory, masticatory, or pharmaceutical stimulation may be considered (weak); chlorhexidine administered as varnish, gel, or rinse may be considered (weak); and nonfluoride remineralizing agents may be considered as an adjunct therapy (moderate). CONCLUSIONS AND PRACTICAL IMPLICATIONS: The incidence of caries in patients with Sjögren disease can be reduced with the use of topical fluoride and other preventive strategies.

9 Guideline 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. 2016

Singh, Jasvinder A / Saag, Kenneth G / Bridges, S Louis / Akl, Elie A / Bannuru, Raveendhara R / Sullivan, Matthew C / Vaysbrot, Elizaveta / McNaughton, Christine / Osani, Mikala / Shmerling, Robert H / Curtis, Jeffrey R / Furst, Daniel E / Parks, Deborah / Kavanaugh, Arthur / O'Dell, James / King, Charles / Leong, Amye / Matteson, Eric L / Schousboe, John T / Drevlow, Barbara / Ginsberg, Seth / Grober, James / St Clair, E William / Tindall, Elizabeth / Miller, Amy S / McAlindon, Timothy. ·University of Alabama at Birmingham. · American University of Beirut, Beirut, Lebanon, and McMaster University, Hamilton, Ontario, Canada. · Tufts Medical Center, Boston, Massachusetts. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · University of California, Los Angeles. · Washington University School of Medicine, St. Louis, Missouri. · University of California, San Diego. · University of Nebraska Medical Center, Omaha. · North Mississippi Medical Center, Tupelo. · Healthy Motivation, Santa Barbara, California. · Mayo Clinic, Rochester, Minnesota. · University of Minnesota and Park Nicollet Clinic, St. Louis Park. · NorthShore University Health System, Evanston, Illinois. · Global Healthy Living Foundation, New York, New York. · Duke University Medical Center, Durham, North Carolina. · Rheumatology Consultants of Oregon, West Linn. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Rheumatol · Pubmed #26545940.

ABSTRACT: OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional). A strong recommendation indicates that clinicians are certain that the benefits of an intervention far outweigh the harms (or vice versa). A conditional recommendation denotes uncertainty over the balance of benefits and harms and/or more significant variability in patient values and preferences. RESULTS: The guideline covers the use of traditional disease-modifying antirheumatic drugs (DMARDs), biologic agents, tofacitinib, and glucocorticoids in early (<6 months) and established (≥6 months) RA. In addition, it provides recommendations on using a treat-to-target approach, tapering and discontinuing medications, and the use of biologic agents and DMARDs in patients with hepatitis, congestive heart failure, malignancy, and serious infections. The guideline addresses the use of vaccines in patients starting/receiving DMARDs or biologic agents, screening for tuberculosis in patients starting/receiving biologic agents or tofacitinib, and laboratory monitoring for traditional DMARDs. The guideline includes 74 recommendations: 23% are strong and 77% are conditional. CONCLUSION: This RA guideline should serve as a tool for clinicians and patients (our two target audiences) for pharmacologic treatment decisions in commonly encountered clinical situations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients through a shared decision-making process taking into account patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

10 Guideline 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. 2016

Singh, Jasvinder A / Saag, Kenneth G / Bridges, S Louis / Akl, Elie A / Bannuru, Raveendhara R / Sullivan, Matthew C / Vaysbrot, Elizaveta / McNaughton, Christine / Osani, Mikala / Shmerling, Robert H / Curtis, Jeffrey R / Furst, Daniel E / Parks, Deborah / Kavanaugh, Arthur / O'Dell, James / King, Charles / Leong, Amye / Matteson, Eric L / Schousboe, John T / Drevlow, Barbara / Ginsberg, Seth / Grober, James / St Clair, E William / Tindall, Elizabeth / Miller, Amy S / McAlindon, Timothy / Anonymous2530848. ·University of Alabama at Birmingham. · American University of Beirut, Beirut, Lebanon, and McMaster University, Hamilton, Ontario, Canada. · Tufts Medical Center, Boston, Massachusetts. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · University of California, Los Angeles. · Washington University School of Medicine, St. Louis, Missouri. · University of California, San Diego. · University of Nebraska Medical Center, Omaha. · North Mississippi Medical Center, Tupelo. · Healthy Motivation, Santa Barbara, California. · Mayo Clinic, Rochester, Minnesota. · University of Minnesota and Park Nicollet Clinic, St. Louis Park. · NorthShore University Health System, Evanston, Illinois. · Global Healthy Living Foundation, New York, New York. · Duke University Medical Center, Durham, North Carolina. · Rheumatology Consultants of Oregon, West Linn. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Care Res (Hoboken) · Pubmed #26545825.

ABSTRACT: OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional). A strong recommendation indicates that clinicians are certain that the benefits of an intervention far outweigh the harms (or vice versa). A conditional recommendation denotes uncertainty over the balance of benefits and harms and/or more significant variability in patient values and preferences. RESULTS: The guideline covers the use of traditional disease-modifying antirheumatic drugs (DMARDs), biologic agents, tofacitinib, and glucocorticoids in early (<6 months) and established (≥6 months) RA. In addition, it provides recommendations on using a treat-to-target approach, tapering and discontinuing medications, and the use of biologic agents and DMARDs in patients with hepatitis, congestive heart failure, malignancy, and serious infections. The guideline addresses the use of vaccines in patients starting/receiving DMARDs or biologic agents, screening for tuberculosis in patients starting/receiving biologic agents or tofacitinib, and laboratory monitoring for traditional DMARDs. The guideline includes 74 recommendations: 23% are strong and 77% are conditional. CONCLUSION: This RA guideline should serve as a tool for clinicians and patients (our two target audiences) for pharmacologic treatment decisions in commonly encountered clinical situations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients through a shared decision-making process taking into account patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

11 Guideline The importance of assessment and management of morning stiffness in Asian patients with rheumatoid arthritis: Recommendations from an expert panel. 2016

Mok, Chi Chiu / Cha, Hoon Suk / Hidayat, Rudy / Nguyen, Lan Thi Ngoc / Perez, Emmanuel C / Ramachandran, Raveendran / Tsay, Gregory J / Yoo, Dae Hyun / Anonymous5770843. ·Department of Medicine, Tuen Mun Hospital, Hong Kong, China. · Sungkyunkwan University, Seoul, South Korea. · Dr Ciptomangunkusumo Hospital, Jakarta, Indonesia. · Hanoi Medical University, Hanoi, Vietnam. · De la Salle University Medical Center, Health Science Institute, Cavite, Philippines. · Sime Darby Medical Centre, Subang Jaya, Malaysia. · Chung Shan Medical University, Taichung, Taiwan. · Hanyang University, Seoul, South Korea. ·Int J Rheum Dis · Pubmed #26403254.

ABSTRACT: OBJECTIVE: In patients with rheumatoid arthritis (RA), morning stiffness is linked more to functional disability and pain than disease activity, as assessed by joint counts and markers of inflammation. As part of the Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel, a group of eight rheumatologists met to formulate consensus points and develop recommendations for the assessment and management of morning stiffness in RA. METHODS: On the basis of a systematic literature review and expert opinion, a panel of Asian rheumatologists formulated recommendations for the assessment and medical treatment of RA. RESULTS: The panel agreed upon 10 consensus statements on morning stiffness, its assessment and treatment. Specifically, the panel recommended that morning stiffness, pain and impaired morning function should be routinely assessed in clinical practice. Although there are currently no validated tools for these parameters, they should be assessed as part of the patients' reported outcomes in RA. The panel also agreed on the benefits of low-dose glucocorticoids in RA, particularly for the improvement of morning stiffness. CONCLUSIONS: These recommendations serve to guide rheumatologists and other stakeholders on the assessment and management of morning stiffness, and help implement the treat-to-target principle in the management of RA.

12 Guideline Recommendations for the treatment of Sjögren's syndrome. 2015

Valim, Valéria / Trevisani, Virgínia Fernandes Moça / Pasoto, Sandra Gofinet / Serrano, Erica Vieira / Ribeiro, Sandra Lúcia Euzébio / Fidelix, Tania Sales de Alencar / Vilela, Verônica Silva / Prado, Leandro Lara do / Tanure, Leandro Augusto / Libório-Kimura, Tatiana Nayara / Brito Filho, Odvaldo Honor de / Barros, Liliana Aparecida Pimenta de / Miyamoto, Samira Tatiyama / Lourenço, Silvia Vanessa / Santos, Maria Carmen Lopes Ferreira Silva / Vieira, Luis Antonio / Adán, Consuelo Bueno Diniz / Bernardo, Wanderley Marques. ·Hospital Universitário Cassiano Antônio de Moraes (Hucam), Empresa Brasileira de Serviços Hospitalares (EBSERH), Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brasil. Electronic address: val.valim@gmail.com. · Departamento de Clínica Médica, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil; Disciplina de Reumatologia, Universidade de Santo Amaro (Unisa), São Paulo, SP, Brasil. · Hospital das Clínicas, Faculdade de Medicina, Departamento de Clínica Médica, Divisão de Reumatologia, Universidade de São Paulo (USP), São Paulo, SP, Brasil. · Hospital Universitário Cassiano Antônio de Moraes (Hucam), Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brasil; Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (Emescam), Vitória, ES, Brasil. · Departamento de Clínica Médica/Reumatologia, Universidade Federal do Amazonas (Ufam), Manaus, AM, Brasil. · Departamento de Clínica Médica, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil. · Disciplina de Reumatologia, Universidade do Estado do Rio de Janeiro (Uerj), Rio de Janeiro, RJ, Brasil. · Departamento do Aparelho Locomotor, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil. · Departamento de Patologia e Medicina Legal, Faculdade de Medicina, Universidade Federal do Amazonas (Ufam), Manaus, AM, Brasil. · Cirurgião-dentista e Periodontista. · Departamento de Clínica Odontológica, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brasil. · Departamento de Educação Integrada em Saúde, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brasil. · Disciplina de Patologia Geral, Faculdade de Odontologia, Universidade de São Paulo (USP), São Paulo, SP, Brasil. · Departamento de Patologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo (Ufes), Vitória, ES, Brasil. · Departamento de Oftalmologia da Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil. · Projeto Diretrizes, Associação Médica Brasileira (AMB), São Paulo, SP, Brasil. ·Rev Bras Reumatol · Pubmed #26360421.

ABSTRACT: The recommendations proposed by the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjögren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 items classified according to Oxford & Grade were included. These recommendations were developed in order to guide the appropriate management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.

13 Guideline APLAR rheumatoid arthritis treatment recommendations. 2015

Lau, Chak Sing / Chia, Faith / Harrison, Andrew / Hsieh, Tsu-Yi / Jain, Rahul / Jung, Seung Min / Kishimoto, Mitsumasa / Kumar, Ashok / Leong, Khai Pang / Li, Zhanguo / Lichauco, Juan Javier / Louthrenoo, Worawit / Luo, Shue-Fen / Nash, Peter / Ng, Chin Teck / Park, Sung-Hwan / Suryana, Bagus Putu Putra / Suwannalai, Parawee / Wijaya, Linda Kurniaty / Yamamoto, Kazuhiko / Yang, Yue / Yeap, Swan Sim / Anonymous6180841. ·Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, University of Hong Kong, Hong Kong. · Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore City, Singapore. · Department of Medicine, University of Otago Wellington, Wellington South, New Zealand. · Section of Allergy, Immunology and Rheumatology, and Section of Clinical Skills Training, Taichung Veterans General Hospital, Taichung, Taiwan. · Narayana Hospital, Jaipur, India. · Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea, St. Mary's Hospital, Seoul, South Korea. · Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan. · Department of Rheumatology, Fortis Flt. Lt Rajan Dhall Hospital, New Delhi, India. · Department of Rheumatology, Peking University People's Hospital, Beijing, China. · St. Luke's Medical Center, Quezon City, Philippines. · Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan. · Department of Medicine, University of Queensland, Brisbane, Queensland, Australia. · Department of Rheumatology and Immunology, Singapore General Hospital, Singapore City, Singapore. · Rheumatology Division, Department of Internal Medicine, Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia. · Allergy, Immunology and Rheumatology Division, Internal Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. · Division of Rheumatology, Department of Internal Medicine, University of Indonesia, Jakarta, Indonesia. · Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Subang Jaya Medical Centre, Selangor, Malaysia. ·Int J Rheum Dis · Pubmed #26334449.

ABSTRACT: 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.

14 Guideline [Preliminary guidelines of the Brazilian Society of Rheumatology for evaluation and treatment of tuberculosis latent infection in patients with rheumatoid arthritis, in face of unavailability of the tuberculin skin test]. 2015

da Mota, Licia Maria Henrique / Cruz, Bóris Afonso / de Albuquerque, Cleandro Pires / Gonçalves, Deborah / Laurindo, Ieda Maria Magalhães / Pereira, Ivanio Alves / de Carvalho, Jozélio Freire / Pinheiro, Geraldo da Rocha Castelar / Bertolo, Manoel Barros / da Silva, Nilzio Antônio / Louzada Júnior, Paulo / Xavier, Ricardo Machado / Giorgi, Rina Dalva Neubarth / Lima, Rodrigo Aires Corrêa. ·Sociedade Brasileira de Reumatologia, São Paulo, SP, Brasil. Electronic address: liciamhmota@gmail.com. · Sociedade Brasileira de Reumatologia, São Paulo, SP, Brasil. ·Rev Bras Reumatol · Pubmed #26165801.

ABSTRACT: -- No abstract --

15 Guideline 2014 update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological therapies in rheumatoid arthritis. 2015

Sanmartí, Raimon / García-Rodríguez, Susana / Álvaro-Gracia, José María / Andreu, José Luis / Balsa, Alejandro / Cáliz, Rafael / Fernández-Nebro, Antonio / Ferraz-Amaro, Iván / Gómez-Reino, Juan Jesús / González-Álvaro, Isidoro / Martín-Mola, Emilio / Martínez-Taboada, Víctor Manuel / Ortiz, Ana M / Tornero, Jesús / Marsal, Sara / Moreno-Muelas, José Vicente. ·Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: sanmarti@clinic.ub.es. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Servicio de Reumatología, Hospital Universitario de la Princesa, Madrid, España. · Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, España. · Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España. · Servicio de Reumatología, Hospital Universitario Virgen de las Nieves, Granada, España. · Unidad de Gestión Clínica de Reumatología, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España. · Servicio de Reumatología, Hospital Universitario de Canarias, Tenerife, España. · Servicio de Reumatología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España. · Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. · Servicio de Reumatología, Hospital Universitario de Guadalajara, Guadalajara, España. · Servicio de Reumatología, Hospital Universitario Vall d́Hebron, Barcelona, España. · Servicio de Reumatología, Hospital Universitario Vall d́Hebron, Barcelona, España; Sociedad Española de Reumatología, Madrid, España. ·Reumatol Clin · Pubmed #26051464.

ABSTRACT: OBJECTIVE: To establish recommendations for the management of patients with rheumatoid arthritis (RA) to serve as a reference for all health professionals involved in the care of these patients, and focusing on the role of available synthetic and biologic disease-modifying antirheumatic drugs (DMARDs). METHODS: Consensual recommendations were agreed on by a panel of 14 experts selected by the Spanish Society of Rheumatology (SER). The available scientific evidence was collected by updating three systematic reviews (SR) used for the EULAR 2013 recommendations. A new SR was added to answer an additional question. The literature review of the scientific evidence was made by the SER reviewer's group. The level of evidence and the degree of recommendation was classified according to the Oxford Centre for Evidence-Based Medicine system. A Delphi panel was used to evaluate the level of agreement between panellists (strength of recommendation). RESULTS: Thirteen recommendations for the management of adult RA were emitted. The therapeutic objective should be to treat patients in the early phases of the disease with the aim of achieving clinical remission, with methotrexate playing a central role in the therapeutic strategy of RA as the reference synthetic DMARD. Indications for biologic DMARDs were updated and the concept of the optimization of biologicals was introduced. CONCLUSIONS: We present the fifth update of the SER recommendations for the management of RA with synthetic and biologic DMARDs.

16 Guideline EULAR recommendations for patient education for people with inflammatory arthritis. 2015

Zangi, Heidi A / Ndosi, Mwidimi / Adams, Jo / Andersen, Lena / Bode, Christina / Boström, Carina / van Eijk-Hustings, Yvonne / Gossec, Laure / Korandová, Jana / Mendes, Gabriel / Niedermann, Karin / Primdahl, Jette / Stoffer, Michaela / Voshaar, Marieke / van Tubergen, Astrid / Anonymous4980822. ·Department of Rheumatology, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · School of Healthcare, University of Leeds, Leeds, UK and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Centre for Innovation and Leadership in Health Faculty of Health Sciences University of Southampton Highfield, Southampton, UK. · Nyborg, Denmark. · Department of Psychology, University of Twente, Health & Technology, Enschede, The Netherlands. · Division of physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. · Department of Patient & Care/ Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands CAPHRI, School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands. · Sorbonne Universités, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Institute of Rheumatology, Prague, Czech Republic. · Department of National Team, Portuguese Cycling Federation, Lisbon, Portugal. · Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland. · Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark Hospital of Southern Jutland, Aabenraa, Denmark King Christian X's Hospital for Rheumatic Diseases, Graasten, Denmark. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. · Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. ·Ann Rheum Dis · Pubmed #25735643.

ABSTRACT: OBJECTIVES: The task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals' educational needs in order to provide evidence-based PE. METHODS: A multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement). RESULTS: Based on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4-9.8). The task force proposed a research agenda and an educational agenda. CONCLUSIONS: The eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.

17 Guideline Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part II. 2015

Saavedra Salinas, Miguel Ángel / Barrera Cruz, Antonio / Cabral Castañeda, Antonio Rafael / Jara Quezada, Luis Javier / Arce-Salinas, C Alejandro / Álvarez Nemegyei, José / Fraga Mouret, Antonio / Orozco Alcalá, Javier / Salazar Páramo, Mario / Cruz Reyes, Claudia Verónica / Andrade Ortega, Lilia / Vera Lastra, Olga Lidia / Mendoza Pinto, Claudia / Sánchez González, Antonio / Cruz Cruz, Polita Del Rocío / Morales Hernández, Sara / Portela Hernández, Margarita / Pérez Cristóbal, Mario / Medina García, Gabriela / Hernández Romero, Noé / Velarde Ochoa, María Del Carmen / Navarro Zarza, José Eduardo / Portillo Díaz, Verónica / Vargas Guerrero, Angélica / Goycochea Robles, María Victoria / García Figueroa, José Luis / Barreira Mercado, Eduardo / Amigo Castañeda, Mary Carmen. ·Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS, UNAM, México, Distrito Federal, México. Electronic address: miansaavsa@gmail.com. · División de Excelencia Clínica, Área de Desarrollo de Guías de Práctica Clínica, IMSS, México, Distrito Federal, México. · Ciencias Médicas F, Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, Distrito Federal, México. · Dirección de Educación e Investigación, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS, UNAM, México, Distrito Federal, México. · División de Medicina Interna, Hospital Central Sur de Pemex, México, Distrito Federal, México. · Escuela de Medicina, Universidad Anáhuac-Mayab, Mérida, Yucatán, México. · Dirección de Educación e Investigación, Secretaría de Salud del Distrito Federal, UNAM, México, Distrito Federal, México. · Clínica de Reumatología, Escuela de Medicina, Universidad de Guadalajara. Guadalajara, Jalisco, México. · División de Investigación en Salud, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, IMSS, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara. Guadalajara, Jalisco, México. · Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS, México, Distrito Federal, México. · Departamento de Reumatología, Centro Médico Nacional 20 de Noviembre, ISSSTE. UNAM, México, Distrito Federal, México. · Departamento de Medicina Interna, Hospital de Especialidades, CMN La Raza, IMSS, UNAM, México, Distrito Federal, México. · Unidad de Investigación Enfermedades Autoinmunes Sistémicas, Hospital General Regional No. 36-CIBIOR, Instituto Mexicano del Seguro Social. Unidad de Posgrado, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México. · División de Atención Ginecoobstétrica y Perinatal de la Dirección de Prestaciones Médicas del IMSS, México, Distrito Federal, México. · Departamento de Perinatología, Hospital Gineco-Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez. UMAE, CMN La Raza, México, Distrito Federal, México. · Departamento de Reumatología, Hospital de Especialidades, CMN Siglo XXI, IMSS, México, Distrito Federal, México. · Hospital de Especialidades, CMN La Raza, IMSS, México, Distrito Federal, México. · Unidad de Cuidados Intensivos Neonatales. Hospital Gineco-Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez. UMAE, CMN La Raza, México, Distrito Federal, México. · Departamento de Reumatología e Inmunología Clínica, Hospital General de Zona No. 46, IMSS, Villahermosa, Tabasco, México. · Hospital General de Chilpancingo Dr. Raymundo Abarca Alarcón, Chilpancingo, Guerrero, México. · Departamento de Medicina Interna, UMAE HGO 4, IMSS, México, Distrito Federal, México. · Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México, Distrito Federal, México. · Unidad de Investigación en Epidemiología Clínica, Hospital Regional Dr. Carlos Mcgregor Sánchez Navarro, IMSS, México, Distrito Federal, México. · Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, México. · Reumatología, Facultad de Medicina, Universidad Autónoma de Querétaro y Universidad del Valle de México. Querétaro, Qro., México. · Reumatología, Centro Médico ABC, México, Distrito Federal, México. ·Reumatol Clin · Pubmed #25683368.

ABSTRACT: BACKGROUND: Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. OBJECTIVES: To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus, rheumatoid arthritis (RA) and antiphospholipid syndrome (APS). METHODOLOGY: Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and staging of recommendations, internal validation by peers and external validation of the final document. The quality criteria of the AGREE II instrument were followed. RESULTS: The panels answered 37 questions related to maternal and fetal care in lupus erythematosus, RA and APS, as well as for use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. In this second part, the recommendations for pregnant women with RA, APS and the use of antirheumatic drugs during pregnancy and lactation are presented. CONCLUSIONS: We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with RA and APS integrate the best available evidence for the treatment and follow-up of patients with these conditions.

18 Guideline Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part I. 2015

Saavedra Salinas, Miguel Ángel / Barrera Cruz, Antonio / Cabral Castañeda, Antonio Rafael / Jara Quezada, Luis Javier / Arce-Salinas, C Alejandro / Álvarez Nemegyei, José / Fraga Mouret, Antonio / Orozco Alcalá, Javier / Salazar Páramo, Mario / Cruz Reyes, Claudia Verónica / Andrade Ortega, Lilia / Vera Lastra, Olga Lidia / Mendoza Pinto, Claudia / Sánchez González, Antonio / Cruz Cruz, Polita Del Rocío / Morales Hernández, Sara / Portela Hernández, Margarita / Pérez Cristóbal, Mario / Medina García, Gabriela / Hernández Romero, Noé / Velarde Ochoa, María Del Carmen / Navarro Zarza, José Eduardo / Portillo Díaz, Verónica / Vargas Guerrero, Angélica / Goycochea Robles, María Victoria / García Figueroa, José Luis / Barreira Mercado, Eduardo / Amigo Castañeda, Mary Carmen. ·Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS; UNAM, México, Distrito Federal, México. Electronic address: miansaavsa@gmail.com. · División de Excelencia Clínica, Área de Desarrollo de Guías de Práctica Clínica, IMSS, México, Distrito Federal, México. · Ciencias Médicas F, Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, Distrito Federal, México. · Dirección de Educación e Investigación, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS, UNAM, México, Distrito Federal, México. · División de Medicina Interna, Hospital Central Sur de Pemex, México, Distrito Federal, México. · Escuela de Medicina, Universidad Anáhuac-Mayab, Mérida, Yucatán, México. · Dirección de Educación e Investigación, Secretaría de Salud del Distrito Federal, UNAM, México, Distrito Federal, México. · Clínica de Reumatología, Escuela de Medicina, Universidad de Guadalajara, Guadalajara, Jalisco, México. · División de Investigación en Salud, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, IMSS, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México. · Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza, IMSS; UNAM, México, Distrito Federal, México. · Departamento de Reumatología, Centro Médico Nacional 20 de Noviembre, ISSSTE, Reumatología, UNAM, México, Distrito Federal, México. · Departamento de Medicina Interna, Hospital de Especialidades, CMN La Raza, IMSS, UNAM, México, Distrito Federal, México. · Unidad de Investigación Enfermedades Autoinmunes Sistémicas, Hospital General Regional n.(o) 36-CIBIOR, Instituto Mexicano del Seguro Social. Unidad de Posgrado, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México. · División de Atención Ginecobstétrica y Perinatal de la Dirección de Prestaciones Médicas del IMSS, México, Distrito Federal, México. · Departamento de Perinatología, Hospital Gineco-Obstetricia n.(o)3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, UMAE, CMN La Raza, IMSS, México, Distrito Federal, México. · Departamento de Reumatología, Hospital de Especialidades, CMN Siglo XXI, IMSS, México, Distrito Federal, México. · Hospital de Especialidades, CMN La Raza, IMSS, México, Distrito Federal, México. · Unidad de Cuidados Intensivos Neonatales, Hospital Gineco-Obstetricia n.(o) 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, UMAE, CMN La Raza, IMSS, México, Distrito Federal, México. · Departamento de Reumatología e Inmunología Clínica, Hospital General de Zona No. 46, IMSS, Villahermosa, Tabasco, México. · Hospital General de Chilpancingo Dr. Raymundo Abarca Alarcón, Chilpancingo, Guerrero, México. · Departamento de Medicina Interna, UMAE HGO 4, IMSS, México, Distrito Federal, México. · Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México, Distrito Federal, México. · Unidad de investigación en Epidemiología Clínica, Hospital Regional Dr. Carlos Mcgregor Sánchez Navarro, IMSS, México, Distrito Federal, México. · Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, México. · Reumatología de la Facultad de Medicina, Universidad Autónoma de Querétaro y Universidad del Del Valle de México, Querétaro, Qro., México. · Reumatología, Centro Médico ABC, México, Distrito Federal, México. ·Reumatol Clin · Pubmed #25639457.

ABSTRACT: BACKGROUND: Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. OBJECTIVES: To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus (SLE), rheumatoid arthritis (RA) and antiphospholipid antibody syndrome (APS). METHODOLOGY: Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and grading of recommendations, internal validation by peers, and external validation of the final document. The quality criteria of the AGREE II instrument were followed. RESULTS: The various panels answered the 37 questions related to maternal and fetal care in SLE, RA, and APS, as well as to the use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. We present the recommendations for pregnant women with SLE in this first part. CONCLUSIONS: We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with SLE integrate the best available evidence for the treatment and follow-up of patients with these conditions.

19 Guideline Recommendations of the French Society for Rheumatology for managing rheumatoid arthritis. 2014

Gaujoux-Viala, Cécile / Gossec, Laure / Cantagrel, Alain / Dougados, Maxime / Fautrel, Bruno / Mariette, Xavier / Nataf, Henri / Saraux, Alain / Trope, Sonia / Combe, Bernard / Anonymous2070799. ·Department of Rheumatology, Nîmes University Hospital, EA 2415, Montpellier I University, 30029 Nîmes, France. Electronic address: cecile.gaujoux.viala@chu-nimes.fr. · Sorbonne Universities, UPMC Univ Paris 06, GRC 08, institut Pierre Louis d'épidémiologie et de santé publique; AP-HP, Department of Rheumatology, CHU Pitié-Salpetrière, 75013 Paris, France. · Department of Rheumatology, Purpan Hospital, CHRU de Toulouse, Paul Sabatier Toulouse III University, UMR Inserm 1043-CNRS 5282, 31059 Toulouse, France. · Paris Descartes University - Department of Rheumatology -Cochin Hospital, Assistance Publique - Hôpitaux de Paris - INSERM (U1153): épidémiologie clinique et biostatistiques, PRES Sorbonne Paris-Cité, 75014 Paris, France. · Department of Rheumatology, Paris-Sud Universities Hospital, AP-HP, Inserm U 1012, Paris Sud University, 92276 Le Kremlin Bicêtre, France. · Cabinet de rhumatologie, 78200 Mantes la Jolie, Yvelines, France. · Department of rheumatology, CHU de la Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France; EA 2216, Bretagne Occidentale University, 29200 Brest, France. · Association nationale de défense contre l'arthrite rhumatoïde (ANDAR), 75014 Paris, France. · Department of rheumatology, Lapeyronie Hospital, CHRU de Montpellier, Montpellier I University, UMR 5535, 34295 Montpellier, France. ·Joint Bone Spine · Pubmed #24986683.

ABSTRACT: INTRODUCTION: This article reports the latest recommendations of the French Society for Rheumatology (SFR) regarding the management of rheumatoid arthritis (RA). METHODS: New recommendations were developed by hospital- and community-based rheumatologists having extensive experience with RA and a patient self-help organization representative. They rest on the recently issued EULAR recommendations and a literature review. RESULTS: Points emphasized in the 15 recommendations include the need to share treatment decisions between the rheumatologist and the patient, the acquisition by patients of self-management skills, remission or minimal disease activity as the treatment target, the need for initiating disease-modifying drugs as early as possible, and the usefulness of regular disease activity assessments to allow rapid treatment adjustments if needed (i.e., tight disease control). First-line methotrexate monotherapy is recommended, with concomitant short-term glucocorticoid therapy if indicated by the risk/benefit ratio. Patients who fail this approach (no response after 3 months or target not achieved after 6 months) can be considered for another synthetic disease-modifying antirheumatic drug (DMARD: leflunomide or sulfasalazine), combined synthetic DMARD therapy, or methotrexate plus a biologic, depending on the prognostic factors and patient characteristics. If the first biologic fails, switching to a second biologic is recommended. In the event of a sustained remission, cautious dosage reduction of the biological and/after synthetic DMARDs is in order. CONCLUSION: These recommendations are designed to improve the management of patients with RA.

20 Guideline [Recommendations for use of abatacept in patients with rheumatoid arthritis]. 2014

Gaubitz, M / Krüger, K / Haas, J-P / Anonymous3920796. ·Akademie für Manuelle Therapie an der WWU Münster, Münster, Deutschland. ·Z Rheumatol · Pubmed #24903655.

ABSTRACT: -- No abstract --

21 Guideline The 2013 BSR and BHPR guideline for the use of intravenous tocilizumab in the treatment of adult patients with rheumatoid arthritis. 2014

Malaviya, Anshuman P / Ledingham, Jo / Bloxham, Jill / Bosworth, Aisla / Buch, Maya / Choy, Ernest / Cope, Andrew / Isaacs, John / Marshall, David / Wright, Gary / Ostör, Andrew J K / Anonymous1130794 / Anonymous1140794. ·Department of Rheumatology, Broomfield Hospital, Chelmsford, Essex, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Addenbrookes Hospital, Cambridge, National Rheumatoid Arthritis Society, Maidenhead, Berkshire, Academic Section of Musculoskeletal Disease, University of Leeds, Leeds, Department of Medicine, Cardiff University School of Medicine, Cardiff, Department of Rheumatology, Kings College London, London, Musculoskeletal Research Group, Newcastle University, Newcastle, Department of Rheumatology, Inverclyde Royal Hospital, Glasgow, Department of Rheumatology, Royal Victoria Hospital, Belfast and Department of Rheumatology, Addenbrookes Hospital, Cambridge, UK. a.malaviya@nhs.net. · Department of Rheumatology, Broomfield Hospital, Chelmsford, Essex, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Addenbrookes Hospital, Cambridge, National Rheumatoid Arthritis Society, Maidenhead, Berkshire, Academic Section of Musculoskeletal Disease, University of Leeds, Leeds, Department of Medicine, Cardiff University School of Medicine, Cardiff, Department of Rheumatology, Kings College London, London, Musculoskeletal Research Group, Newcastle University, Newcastle, Department of Rheumatology, Inverclyde Royal Hospital, Glasgow, Department of Rheumatology, Royal Victoria Hospital, Belfast and Department of Rheumatology, Addenbrookes Hospital, Cambridge, UK. ·Rheumatology (Oxford) · Pubmed #24821853.

ABSTRACT: -- No abstract --

22 Guideline [Evidence-based recommendations for the management of undifferentiated peripheral inflammatory arthritis (UPIA). The German perspective on the international 3e initiative]. 2014

Tarner, I H / Albrecht, K / Fleck, M / Gromnica-Ihle, E / Keyßer, G / Köhler, L / Kötter, I / Krüger, K / Kuipers, J / Nüßlein, H / Rubbert-Roth, A / Wollenhaupt, J / Schneider, M / Manger, B / Müller-Ladner, U / Anonymous20787. ·Abt. für Rheumatologie, Klinische Immunologie, Osteologie und Physikalische Medizin,Kerckhoff-Klinik, Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie, Justus-Liebig-Universität Gießen, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland. ·Z Rheumatol · Pubmed #24590079.

ABSTRACT: INTRODUCTION: Peripheral arthritis is the most common presenting complaint in clinical rheumatology. Unequivocal identification of the underlying entity can be difficult, particularly at an early stage. Such cases are commonly referred to as undifferentiated peripheral inflammatory arthritis (UPIA). Since evidence-based recommendations for the clinical management of UPIA are lacking, this international 3e initiative convened 697 rheumatologists from 17 countries to develop appropriate recommendations. METHODS: Based on a systematic literature research in Medline, EMBASE, Cochrane Library, and the ACR/EULAR abstracts of 2007/2008, 10 multinational recommendations were developed by 3 rounds of a Delphi process. In Germany, a national group of experts worked on 3 additional recommendations using the same method. The recommendations were discussed among the members of the 3e initiative and the degree of consensus was analyzed as well as the potential impact of the recommendations on clinical practice. RESULTS: A total of 39,756 references were identified, of which 250 were systematically reviewed for the development of 10 multinational recommendations concerning differential diagnosis, diagnostic and prognostic value of clinical assessments, laboratory tests and imaging techniques, and monitoring of UPIA. In addition, 3 national recommendations on the diagnostic and prognostic value of a response to anti-inflammatory therapy on the analysis of synovial fluid and on enthesitis were developed by the German experts based on 35 out of 5542 references. CONCLUSIONS: The article translates the 2011 published original paper of the international 3e initiative (Machado et al., Ann Rheum Dis 70:15-24, 2011) and reports the methods and results of the national vote and the additional 3 national recommendations.

23 Guideline Update of the Mexican College of Rheumatology guidelines for the pharmacologic treatment of rheumatoid arthritis. 2014

Cardiel, Mario H / Díaz-Borjón, Alejandro / Vázquez del Mercado Espinosa, Mónica / Gámez-Nava, Jorge Iván / Barile Fabris, Leonor A / Pacheco Tena, César / Silveira Torre, Luis H / Pascual Ramos, Virginia / Goycochea Robles, María Victoria / Aguilar Arreola, Jorge Enrique / González Díaz, Verónica / Alvarez Nemegyei, José / González-López, Laura del Carmen / Salazar Páramo, Mario / Portela Hernández, Margarita / Castro Colín, Zully / Xibillé Friedman, Daniel Xavier / Alvarez Hernández, Everardo / Casasola Vargas, Julio / Cortés Hernández, Miguel / Flores-Alvarado, Diana E / Martínez Martínez, Laura A / Vega-Morales, David / Flores-Suárez, Luis Felipe / Medrano Ramírez, Gabriel / Barrera Cruz, Antonio / García González, Adolfo / López López, Susana Marisela / Rosete Reyes, Alejandra / Espinosa Morales, Rolando / Anonymous5330778. ·Jefe de la Unidad de Investigación «Dr. Mario Alvizouri Muñoz», Hospital General «Dr. Miguel Silva», Secretaría de Salud de Michoacán, Morelia, Michoacán, México. · Profesor Titular del Curso de Especialización en Medicina Interna, Hospital Ángeles Lomas/UNAM, Huixquilucan, Estado de México, México. · Reumatólogo del Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Jefa del Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México. · Investigador de UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS. Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México. · Reumatóloga y Doctora en Ciencias de la Salud, Jefa del departamento de Reumatología HE CMNSXXI IMSS, Profesora titular del curso de especialización en Reumatología, miembro titular del Sistema Nacional de Investigadores, México Distrito Federal, México. · Reumatólogo, Profesor-investigador de la Facultad de Medicina de la Universidad Autónoma de Chihuahua, Chihuahua, México. · Médico adjunto, Profesor adjunto Curso de Reumatología, Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México Distrito Federal, México. · Médico adscrito del Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México Distrito Federal, México. · Reumatóloga, investigadora titular A, adscrita a la Unidad de Investigación en Epidemiología Clínica del Hospital General Regional Núm. 1. «Dr. Carlos McGregor Sánchez Navarro», IMSS, México Distrito Federal, México. · Reumatólogo del Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México. · Reumatóloga del Antiguo Hospital Civil de Guadalajara «Fray Antonio Alcalde», Guadalajara, México. · Profesor Investigador de la escuela de Medicina de la Universidad Anáhuac-Mayab, Mérida, Yucatán, México. · Reumatólogo del Hospital General Regional 110 del IMSS, Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México. · Jefe de la División de Investigación de la UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS. Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México. · Adscrita al Departamento de Reumatología del Hospital de Especialidades del CMN SXXI, México Distrito Federal, México. · Adscrita al Departamento de Reumatología de HGZ 27 IMSS, México Distrito Federal, México. · Departamento de Reumatología, Hospital General de Cuernavaca «Dr. José G. Parres», SSM, Morelos, México. · Reumatólogo, Hospital General de México, México Distrito Federal, México. · Medicina Interna-Reumatología, Profesor de Fisiología Humana, Facultad de Medicina, Universidad Autónoma de Estado de Morelos, Morelos, México. · Profesora de Medicina Interna y Reumatología, Hospital Universitario «José E. González», Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. · Investigadora titular, Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México Distrito Federal, México. · Hospital Universitario «José E. González», Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. · Reumatólogo, Jefe de la Clínica de Vasculitis Sistémicas Primarias, Instituto Nacional de Enfermedades Respiratorias, Investigador en Ciencias Médicas «D», México Distrito Federal, México. · Médico internista y reumatólogo, Adscrito al Servicio de Reumatología, Hospital General de México. Presidente del Consejo Mexicano de Reumatología, México Distrito Federal, México. · Reumatólogo, Maestro en Ciencias Médicas, Coordinador de Programas Médicos, adscrito a la División de Excelencia Clínica, área de Desarrollo de Guías de Práctica Clínica de la Coordinación de Unidades Médicas de Alta Especialidad del IMSS , México Distrito Federal, México. · Reumatólogo, Doctor en Ciencias Médicas, Hospital General de Zona IMSS, La Paz, Baja California Sur, México. · Reumatóloga adscrita al servicio de Reumatología, Hospital Ángeles del Carmen, Guadalajara, Jalisco, México. · Reumatóloga especializada en Fármaco-vigilancia, Jefe de operaciones Centro de Investigación en Farmacología y Biotecnología, Médica Sur, México Distrito Federal, México. · Profesor titular de Reumatología, UNAM, Jefe del Departamento de Reumatología, Instituto Nacional de Rehabilitación, México Distrito Federal, México. Electronic address: rolespi@yahoo.com. ·Reumatol Clin · Pubmed #24333119.

ABSTRACT: BACKGROUND: The pharmacologic management of rheumatoid arthritis has progressed substantially over the past years. It is therefore desirable that existing information be periodically updated. There are several published international guidelines for the treatment of rheumatoid arthritis that hardly adapt to the Mexican health system because of its limited healthcare resources. Hence, it is imperative to unify the existing recommendations and to incorporate them to a set of clinical, updated recommendations; the Mexican College of Rheumatology developed these recommendations in order to offer an integral management approach of rheumatoid arthritis according to the resources of the Mexican health system. OBJECTIVE: To review, update and improve the available evidence within clinical practice guidelines on the pharmacological management of rheumatoid arthritis and produce a set of recommendations adapted to the Mexican health system, according to evidence available through December 2012. METHODS: The working group was composed of 30 trained and experienced rheumatologists with a high quality of clinical knowledge and judgment. Recommendations were based on the highest quality evidence from the previously established treatment guidelines, meta-analysis and controlled clinical trials for the adult population with rheumatoid arthritis. RESULTS: During the conformation of this document, each working group settled the existing evidence from the different topics according to their experience. Finally, all the evidence and decisions were unified into a single document, treatment algorithm and drug standardization tables. CONCLUSIONS: This update of the Mexican Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis provides the highest quality information available at the time the working group undertook this review and contextualizes its use for the complex Mexican health system.

24 Guideline EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. 2014

Smolen, Josef S / Landewé, Robert / Breedveld, Ferdinand C / Buch, Maya / Burmester, Gerd / Dougados, Maxime / Emery, Paul / Gaujoux-Viala, Cécile / Gossec, Laure / Nam, Jackie / Ramiro, Sofia / Winthrop, Kevin / de Wit, Maarten / Aletaha, Daniel / Betteridge, Neil / Bijlsma, Johannes W J / Boers, Maarten / Buttgereit, Frank / Combe, Bernard / Cutolo, Maurizio / Damjanov, Nemanja / Hazes, Johanna M W / Kouloumas, Marios / Kvien, Tore K / Mariette, Xavier / Pavelka, Karel / van Riel, Piet L C M / Rubbert-Roth, Andrea / Scholte-Voshaar, Marieke / Scott, David L / Sokka-Isler, Tuulikki / Wong, John B / van der Heijde, Désirée. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, , Vienna, Austria. ·Ann Rheum Dis · Pubmed #24161836.

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 at 3 months). Tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, biosimilars), abatacept, tocilizumab and, under certain circumstances, rituximab are essentially considered to have similar efficacy and safety. If the first bDMARD strategy fails, any other bDMARD may be used. The recommendations also address tofacitinib as a targeted sDMARD (tsDMARD), which is recommended, where licensed, after use of at least one bDMARD. Biosimilars are also addressed. These recommendations are intended to inform rheumatologists, patients, national rheumatology societies and other stakeholders about EULAR's most recent consensus on the management of RA with sDMARDs, glucocorticoids and bDMARDs. They are based on evidence and expert opinion and intended to improve outcome in patients with RA.

25 Guideline German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. 2014

Albrecht, Katinka / Krüger, Klaus / Wollenhaupt, Jürgen / Alten, Rieke / Backhaus, Marina / Baerwald, Christoph / Bolten, Wolfgang / Braun, Jürgen / Burkhardt, Harald / Burmester, Gerd R / Gaubitz, Markus / Gause, Angela / Gromnica-Ihle, Erika / Kellner, Herbert / Kuipers, Jens / Krause, Andreas / Lorenz, Hans-Martin / Manger, Bernhard / Nüßlein, Hubert / Pott, Hans-Georg / Rubbert-Roth, Andrea / Schneider, Matthias / Specker, Christof / Schulze-Koops, Hendrik / Tony, Hans-Peter / Wassenberg, Siegfried / Müller-Ladner, Ulf / Anonymous5560766. ·German Society of Rheumatology, Berlin, Germany, katinka.albrecht@dgrh.de. ·Rheumatol Int · Pubmed #23942828.

ABSTRACT: The German Society of Rheumatology approved new German guidelines for the sequential medical treatment of rheumatoid arthritis (RA) based on the European League Against Rheumatism (EULAR) recommendations for the management of RA published in 2010. An update of the EULAR systematic literature research was performed in Medline, Embase, and Cochrane databases. Meta-analyses, controlled trials, cohort studies, and registry data addressing traditional and biologic disease-modifying antirheumatic drugs, glucocorticoids, and treatment strategies published between January 2009 and August 2011 were included. Two reviewers independently evaluated and compared the additional data that had been published after the time limit set by the EULAR recommendations. A national guideline working group developed an adapted set of recommendations. The new German guidelines were accepted by vote using an informal Delphi approach. Twelve recommendations and the resulting updated treatment algorithm were developed and approved as a practical orientation for rheumatologists. These recommendations are based on a successive treatment with traditional and biologic disease-modifying drugs depending on the individual progress of the disease and distinct patient characteristics. The German guidelines have been developed on the basis of the internationally well-recognized EULAR recommendations. In addition, more recent evidence from a systematic literature research was considered. They have been developed and approved by a group of national experts aiming at guidance for rheumatologists to reach best medical practice.

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