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Rheumatoid Arthritis HELP
Based on 26,733 articles since 2008
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These are the 26733 published articles about Arthritis, Rheumatoid that originated from Worldwide during 2008-2017.
 
+ 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 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.

2 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 / Anonymous4620848. ·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.

3 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 / Anonymous970968. ·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.

4 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 / Anonymous8460841. ·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.

5 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.

6 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 / Anonymous6760822. ·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.

7 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.

8 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.

9 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 / Anonymous3360799. ·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.

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

Gaubitz, M / Krüger, K / Haas, J-P / Anonymous5280796. ·Akademie für Manuelle Therapie an der WWU Münster, Münster, Deutschland. · ·Z Rheumatol · Pubmed #24903655.

ABSTRACT: -- No abstract --

11 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 / Anonymous2230794 / Anonymous2240794. ·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 --

12 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 / Anonymous890787. ·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.

13 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 / Anonymous590779. ·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.

14 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.

15 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 / Anonymous360767. ·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.

16 Guideline [The proposal of the Croatian Society for Rheumatology for the treatment of adult rheumatoid arthritis patients with biologics, 2013]. 2013

Babić-Naglić, Durdica / Anić, Branimir / Čikeš, Nada / Novak, Srdan / Grazio, Simeon / Morović-Vergles, Jadranka / Kehler, Tatjana / Marasović-Krstulović, Daniela / Milanović, Sonja / Hanih, Marino / Perić, Porin / Vlak, Tonko / Potokič, Kristina / Ćurković, Božidar / Anonymous5980768. ·Klinika za reumatske bolesti i rehabilitaciju Klinicki bolnicki centar Zagreb. dnaglic@kbc-zagreb.hr · ·Reumatizam · Pubmed #24003685.

ABSTRACT: Standardized approach to the patients with rheumatoid arthritis (RA) is one of the requirements of good clinical practice. Croatian Society for Rheumatology (HRD) of Croatian Medical Association (HLZ) updated the Proposed treatment of rheumatoid arthritis (RA) with biologic agents in line with recent findings in rheumatology for the last 3 years. By complying with the agreed standards of treatment we can avoid malpractice and irrational consumption, and to the most patients provide a greater chance for a favorable outcome.

17 Guideline South African recommendations for the management of rheumatoid arthritis: an algorithm for the standard of care in 2013. 2013

Hodkinson, Bridget / Van Duuren, Elsa / Pettipher, Clive / Kalla, Asgar / Anonymous1370765. ·Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa. drbridget@gmail.com · ·S Afr Med J · Pubmed #23885741.

ABSTRACT: Updated treatment recommendations for the therapy of rheumatoid arthritis (RA) in South Africa advocate early diagnosis, prompt initiation of disease-modifying anti-rheumatic drugs (DMARDs), and an intense treatment strategy where disease activity is assessed with a composite score such as the Simplified Disease Activity Index (SDAI). Frequent assessments and escalation of therapy are necessary until low disease activity (LDA) (SDAI ≤11) or ideally remission (SDAI ≤3.3) is achieved. Synthetic DMARDs may be used as monotherapy or in combination, and can be co-prescribed with low-dose corticosteroids if necessary. Biologic DMARD therapy should be considered for patients who have failed a 6-month trial of at least 3 synthetic DMARDs. All RA patients in SA are at increased risk of tuberculosis (TB), in particular patients using anti-tumour necrosis factor (TNF) biologic therapy. These recommendations provide practical suggestions for the screening and management of TB and other comorbidities, and offer an approach to monitoring of RA patients.

18 Guideline Guidelines for the drug treatment of rheumatoid arthritis. 2013

Mota, Licia Maria Henrique da / Cruz, Bóris Afonso / Brenol, Claiton Viegas / Pereira, Ivânio Alves / Rezende-Fronza, Lucila Stange / Bertolo, Manoel Barros / Freitas, Max Vitor Carioca / Silva, Nilzio Antônio da / Louzada-Junior, Paulo / Giorgi, Rina Dalva Neubarth / Lima, Rodrigo Aires Corrêa / Bernardo, Wanderley Marques / Pinheiro, Geraldo da Rocha Castelar / Anonymous1970764. ·liciamhmota@gmail.com · ·Rev Bras Reumatol · Pubmed #23856794.

ABSTRACT: -- No abstract --

19 Guideline Guidelines for the diagnosis of rheumatoid arthritis. 2013

Mota, Licia Maria Henrique da / Cruz, Bóris Afonso / Brenola, Claiton Viegas / Pereira, Ivânio Alves / Rezende-Fronza, Lucila Stange / Bertolo, Manoel Barros / Freitas, Max Vitor Carioca / Silva, Nilzio Antônio da / Louzada-Junior, Paulo / Giorgi, Rina Dalva Neubarth / Lima, Rodrigo Aires Corrêa / Kairalla, Ronaldo Adib / Kawassaki, Alexandre de Melo / Bernardo, Wanderley Marques / Pinheiro, Geraldo da Rocha Castelar / Anonymous1940764 / Anonymous1950764 / Anonymous1960764. ·liciamhmota@gmail.com · ·Rev Bras Reumatol · Pubmed #23856793.

ABSTRACT: -- No abstract --

20 Guideline 2012 Brazilian Society of Rheumatology Consensus on vaccination of patients with rheumatoid arthritis. 2013

Brenol, Claiton Viegas / da Mota, Licia Maria Henrique / Cruz, Bóris Afonso / Pileggi, Gecilmara Salviato / Pereira, Ivânio Alves / Rezende, Lucila Stange / Bertolo, Manoel Barros / Freitas, Max Victor Carioca / Silva, Nilzio Antônio da / Louzada-Junior, Paulo / Giorgi, Rina Dalva Neubarth / Lima, Rodrigo Aires Corrêa / Pinheiro, Geraldo da Rocha Castelar / Anonymous620999. ·Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Brazil. cbrenol@hcpa.ufrgs.br · ·Rev Bras Reumatol · Pubmed #23588512.

ABSTRACT: OBJECTIVE: To elaborate recommendations to the vaccination of patients with rheumatoid arthritis (RA) in Brazil. METHOD: Literature review and opinion of expert members of the Brazilian Society of Rheumatology Committee of Rheumatoid Arthritis and of an invited pediatric rheumatologist. RESULTS AND CONCLUSIONS: The following 12 recommendations were established: 1) Before starting disease-modifying anti-rheumatic drugs, the vaccine card should be reviewed and updated; 2) Vaccines against seasonal influenza and against H1N1 are indicated annually for patients with RA; 3) The pneumococcal vaccine should be indicated for all patients with RA; 4) The vaccine against varicella should be indicated for patients with RA and a negative or dubious history for that disease; 5) The HPV vaccine should be considered for adolescent and young females with RA; 6) The meningococcal vaccine is indicated for patients with RA only in the presence of asplenia or complement deficiency; 7) Asplenic adults with RA should be immunized against Haemophilus influenzae type B; 8) An additional BCG vaccine is not indicated for patients diagnosed with RA; 9) Hepatitis B vaccine is indicated for patients with RA who are negative for antibodies against HBsAg; the combined hepatitis A and B vaccine should be considered; 10) Patients with RA and at high risk for tetanus, who received rituximab in the preceding 24 weeks, should undergo passive immunization with tetanus immunoglobulin in case of exposure; 11) The YF vaccine is contraindicated to patients with RA on immunosuppressive drugs; 12) The above described recommendations should be reviewed over the course of RA.

21 Guideline EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. 2013

Colebatch, Alexandra N / Edwards, Christopher John / Østergaard, Mikkel / van der Heijde, Désirée / Balint, Peter V / D'Agostino, Maria-Antonietta / Forslind, Kristina / Grassi, Walter / Haavardsholm, Espen A / Haugeberg, Glenn / Jurik, Anne-Grethe / Landewé, Robert B M / Naredo, Esperanza / O'Connor, Philip J / Ostendorf, Ben / Potocki, Kristina / Schmidt, Wolfgang A / Smolen, Josef S / Sokolovic, Sekib / Watt, Iain / Conaghan, Philip G. ·Department of Rheumatology, University Hospital Southampton, Southampton, UK. · ·Ann Rheum Dis · Pubmed #23520036.

ABSTRACT: OBJECTIVE: To develop evidence-based recommendations on the use of imaging of the joints in the clinical management of rheumatoid arthritis (RA). METHODS: The task force comprised an expert group of rheumatologists, radiologists, methodologists and experienced rheumatology practitioners from 13 countries. Thirteen key questions on the role of imaging in RA were generated using a process of discussion and consensus. Imaging modalities included were conventional radiography, ultrasound, MRI, CT, dual-emission x-ray absorptiometry, digital x-ray radiogrammetry, scintigraphy and positron emission tomography. Research evidence was searched systematically for each question using MEDLINE, EMBASE and Cochrane CENTRAL. The experts used the evidence obtained from the relevant studies to develop a set of 10 recommendations. The strength of recommendation was assessed using a visual analogue scale. RESULTS: A total of 6888 references was identified from the search process, from which 199 studies were included in the systematic review. Ten recommendations were produced encompassing the role of imaging in making a diagnosis of RA, detecting inflammation and damage, predicting outcome and response to treatment, monitoring disease activity, progression and remission. The strength of recommendation for each proposition varied according to both the research evidence and expert opinion. CONCLUSIONS: Ten key recommendations for the role of imaging in the management of RA were developed using research-based evidence and expert opinion.

22 Guideline Abatacept use in rheumatoid arthritis: evidence review and recommendations. 2013

Martín Mola, Emilio / Balsa, Alejandro / Martínez Taboada, Víctor / Sanmartí, Raimon / Marenco, José Luis / Navarro Sarabia, Federico / Gómez-Reino, Juan / Alvaro-Gracia, José María / Román Ivorra, José Andrés / Lojo, Leticia / Plasencia, Chamaida / Carmona, Loreto / Anonymous12500730. ·Servicio de Reumatología, Hospital Universitario La Paz, IdiPAZ, Madrid, España. emartinmola.hulp@salud.madrid.org · ·Reumatol Clin · Pubmed #22766432.

ABSTRACT: OBJECTIVE: To review the clinical evidence on abatacept and to formulate recommendations in order to clear up points related to its use in rheumatology. METHOD: An expert panel of rheumatologists objectively summarized the evidence on the mechanism of action, practicalities, effectiveness and safety of abatacept, and formulated recommendations following a literature review. The level of evidence and degree of recommendation was established. RESULTS: The document presents 21 statements focused on evidence or recommendations on abatacept (14 evidence summaries and 9 recommendations). The level of evidence was 2b or higher according to the Oxford Centre for Evidence-Based Medicine scale on 14 occasions. The degree of the recommendation was A in two recommendations, C in one, and D in the rest. It was considered important to make recommendations on aspects with lower levels of evidence. CONCLUSIONS: This is a practical document to supplement the summary of product characteristics.

23 Guideline [German 2012 guidelines for the sequential medical treatment of rheumatoid arthritis. Adapted EULAR recommendations and updated treatment algorithm]. 2012

Krüger, K / Wollenhaupt, J / Albrecht, K / Alten, R / Backhaus, M / Baerwald, C / Bolten, W / Braun, J / Burkhardt, H / Burmester, G / Gaubitz, M / Gause, A / Gromnica-Ihle, E / Kellner, H / Kuipers, J / Krause, A / Lorenz, H-M / Manger, B / Nüßlein, H / Pott, H-G / Rubbert-Roth, A / Schneider, M / Specker, C / Schulze-Koops, H / Tony, H-P / Wassenberg, S / Müller-Ladner, U / Anonymous4160735. ·Praxiszentrum Rheumatologie, St. Bonifatius Str. 5, 81541, München, Deutschland. Klaus.Krueger@med.uni-muenchen.de · ·Z Rheumatol · Pubmed #22930110.

ABSTRACT: Following the EULAR recommendations published in 2010 German guidelines for the medical treatment of rheumatoid arthritis were developed based on an update of the systematic literature search and expert consensus. Methotrexate is the standard treatment option at the time of diagnosis, preferably in combination with low dose glucocorticoids. Combined disease-modifying antirheumatic drugs (DMARD) therapy should be considered in patients not responding within 12 weeks. Treatment with biologicals should be initiated in patients with persistent high activity no later than 6 months after conventional treatment and in exceptional situations (e.g. early destruction or unfavorable prognosis) even earlier. If treatment with biologicals remains ineffective, changing to another biological is recommended after 3-6 months. In cases of long-standing remission a controlled reduction of medical treatment can be considered.

24 Guideline Current considerations for the management of musculoskeletal pain in Asian countries: a special focus on cyclooxygenase-2 inhibitors and non-steroid anti-inflammation drugs. 2012

Pongparadee, Chaudakshetrin / Penserga, Ester / Lee, David Jeng-Shiang / Chen, Shun-le / Gill, Ranjit Singh / Hamid, Abdulbar / Kumthornthip, Witsanu / Liu, Yi / Meliala, Lucus / Misbach, H Jusuf / Tan, Kian Hian / Yeap, Swan Sim / Yeo, Sow Nam / Lin, Hsiao Yi. ·Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. · ·Int J Rheum Dis · Pubmed #22898213.

ABSTRACT: Chronic pain is a complex problem that eludes precise definition and can be clinically difficult to diagnose and challenging to treat. In the Asia-Pacific region, prevalence estimates that chronic pain ranges from 12% to 45% of the population, with musculoskeletal, rheumatic or osteoarthritis pain making up the majority of the disease burden. Implementation of current management guidelines into routine clinical practice has been challenging and as a result, patients with musculoskeletal pain are often poorly managed. For these reasons, a multidisciplinary Chronic Pain Advisory Board of leading physicians from various Asian countries was convened to explore ways to improve treatment and compliance, especially among patients with osteoarthritis and rheumatoid arthritis. We have identified a number of unmet therapeutic needs and prioritized initiatives with the potential to contribute toward a more integrated approach to chronic pain management. Key priorities included using evidence-based interventions as recommended by current guidelines, particularly those aspects pertinent to addressing treatment priorities in Asia (e.g., patient compliance), and the incorporation of cyclooxygenase-2 inhibitors and non-steroid anti-inflammation drugs into the management algorithms for osteoarthritis and rheumatoid arthritis. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics and long-term efficacy outcomes. Our increasing understanding of the problem combined with the promise of new therapy options offers hope for improved management of musculoskeletal pain in Asian countries.

25 Guideline 2012 Brazilian Society of Rheumatology Consensus on the management of comorbidities in patients with rheumatoid arthritis. 2012

Pereira, Ivânio Alves / Mota, Licia Maria Henrique da / Cruz, Boris Afonso / Brenol, Claiton Viegas / Fronza, Lucila Stange Rezende / Bertolo, Manoel Barros / Freitas, Max Victor Carioca de / Silva, Nilzio Antônio da / Louzada-Junior, Paulo / Giorgi, Rina Dalva Neubarth / Lima, Rodrigo Aires Corrêa / Pinheiro, Geraldo da Rocha Castelar / Anonymous1390734. ·Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil. ivanioreumato@gmail.com · ·Rev Bras Reumatol · Pubmed #22885417.

ABSTRACT: OBJECTIVE: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA). METHODS: To review the literature and the opinions of the SBR RA Committee experts. RECOMMENDATIONS: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specific treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities.

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