EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs
| Autor(a) principal: | |
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| Data de Publicação: | 2022 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/147368 |
Resumo: | Funding Information: This study was funded by European League Against Rheumatism. Publisher Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. |
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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs2022 updateAntirheumatic AgentsArthritis, RheumatoidBiological TherapyRheumatologyImmunology and AllergyImmunologyBiochemistry, Genetics and Molecular Biology(all)Funding Information: This study was funded by European League Against Rheumatism. Publisher Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.Objectives: To provide an update of the EULAR rheumatoid arthritis (RA) management recommendations addressing the most recent developments in the field. Methods: An international task force was formed and solicited three systematic literature research activities on safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs). The new evidence was discussed in light of the last update from 2019. A predefined voting process was applied to each overarching principle and recommendation. Levels of evidence and strengths of recommendation were assigned to and participants finally voted on the level of agreement with each item. Results: The task force agreed on 5 overarching principles and 11 recommendations concerning use of conventional synthetic (cs) DMARDs (methotrexate (MTX), leflunomide, sulfasalazine); GCs; biological (b) DMARDs (tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab including biosimilars), abatacept, rituximab, tocilizumab, sarilumab and targeted synthetic (ts) DMARDs, namely the Janus kinase inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib. Guidance on monotherapy, combination therapy, treatment strategies (treat-to-target) and tapering in sustained clinical remission is provided. Safety aspects, including risk of major cardiovascular events (MACEs) and malignancies, costs and sequencing of b/tsDMARDs were all considered. Initially, MTX plus GCs is recommended and on insufficient response to this therapy within 3-6 months, treatment should be based on stratification according to risk factors; With poor prognostic factors (presence of autoantibodies, high disease activity, early erosions or failure of two csDMARDs), any bDMARD should be added to the csDMARD; after careful consideration of risks of MACEs, malignancies and/or thromboembolic events tsDMARDs may also be considered in this phase. If the first bDMARD (or tsDMARD) fails, any other bDMARD (from another or the same class) or tsDMARD (considering risks) is recommended. With sustained remission, DMARDs may be tapered but should not be stopped. Levels of evidence and levels of agreement were high for most recommendations. Conclusions: These updated EULAR recommendations provide consensus on RA management including safety, effectiveness and cost.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Comprehensive Health Research Centre (CHRC) - pólo NMSRUNSmolen, Josef S.Landewé, Robert B.M.Bergstra, Sytske AnneKerschbaumer, AndreasSepriano, AlexandreAletaha, DanielCaporali, RobertoEdwards, Christopher JohnHyrich, Kimme L.Pope, Janet E.De Souza, SaviaStamm, Tanja A.Takeuchi, TsutomuVerschueren, PatrickWinthrop, Kevin L.Balsa, AlejandroBathon, Joan M.Buch, Maya H.Burmester, Gerd R.Buttgereit, FrankCardiel, Mario HumbertoChatzidionysiou, KaterinaCodreanu, CatalinCutolo, MaurizioDen Broeder, Alfons A.El Aoufy, KhadijaFinckh, AxelFonseca, João EuricoGottenberg, Jacques EricHaavardsholm, Espen A.Iagnocco, AnnamariaLauper, KimLi, ZhanguoMcInnes, Iain B.Mysler, Eduardo F.Nash, PeterPoor, GyulaRistic, Gorica G.Rivellese, FeliceRubbert-Roth, AndreaSchulze-Koops, HendrikStoilov, NikolayStrangfeld, AnjaVan Der Helm-Van Mil, AnnetteVan Duuren, ElsaVliet Vlieland, Theodora P.M.Westhovens, RenéVan Der Heijde, DésiréeSmolen, Josef S.2023-01-11T22:18:02Z2022-112022-11-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/147368eng0003-4967PURE: 48346601https://doi.org/10.1136/ard-2022-223356info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-05-22T18:08:00Zoai:run.unl.pt:10362/147368Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-05-22T18:08Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs 2022 update |
| title |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| spellingShingle |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs Smolen, Josef S. Antirheumatic Agents Arthritis, Rheumatoid Biological Therapy Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| title_short |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| title_full |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| title_fullStr |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| title_full_unstemmed |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| title_sort |
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs |
| author |
Smolen, Josef S. |
| author_facet |
Smolen, Josef S. Landewé, Robert B.M. Bergstra, Sytske Anne Kerschbaumer, Andreas Sepriano, Alexandre Aletaha, Daniel Caporali, Roberto Edwards, Christopher John Hyrich, Kimme L. Pope, Janet E. De Souza, Savia Stamm, Tanja A. Takeuchi, Tsutomu Verschueren, Patrick Winthrop, Kevin L. Balsa, Alejandro Bathon, Joan M. Buch, Maya H. Burmester, Gerd R. Buttgereit, Frank Cardiel, Mario Humberto Chatzidionysiou, Katerina Codreanu, Catalin Cutolo, Maurizio Den Broeder, Alfons A. El Aoufy, Khadija Finckh, Axel Fonseca, João Eurico Gottenberg, Jacques Eric Haavardsholm, Espen A. Iagnocco, Annamaria Lauper, Kim Li, Zhanguo McInnes, Iain B. Mysler, Eduardo F. Nash, Peter Poor, Gyula Ristic, Gorica G. Rivellese, Felice Rubbert-Roth, Andrea Schulze-Koops, Hendrik Stoilov, Nikolay Strangfeld, Anja Van Der Helm-Van Mil, Annette Van Duuren, Elsa Vliet Vlieland, Theodora P.M. Westhovens, René Van Der Heijde, Désirée |
| author_role |
author |
| author2 |
Landewé, Robert B.M. Bergstra, Sytske Anne Kerschbaumer, Andreas Sepriano, Alexandre Aletaha, Daniel Caporali, Roberto Edwards, Christopher John Hyrich, Kimme L. Pope, Janet E. De Souza, Savia Stamm, Tanja A. Takeuchi, Tsutomu Verschueren, Patrick Winthrop, Kevin L. Balsa, Alejandro Bathon, Joan M. Buch, Maya H. Burmester, Gerd R. Buttgereit, Frank Cardiel, Mario Humberto Chatzidionysiou, Katerina Codreanu, Catalin Cutolo, Maurizio Den Broeder, Alfons A. El Aoufy, Khadija Finckh, Axel Fonseca, João Eurico Gottenberg, Jacques Eric Haavardsholm, Espen A. Iagnocco, Annamaria Lauper, Kim Li, Zhanguo McInnes, Iain B. Mysler, Eduardo F. Nash, Peter Poor, Gyula Ristic, Gorica G. Rivellese, Felice Rubbert-Roth, Andrea Schulze-Koops, Hendrik Stoilov, Nikolay Strangfeld, Anja Van Der Helm-Van Mil, Annette Van Duuren, Elsa Vliet Vlieland, Theodora P.M. Westhovens, René Van Der Heijde, Désirée |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Comprehensive Health Research Centre (CHRC) - pólo NMS RUN |
| dc.contributor.author.fl_str_mv |
Smolen, Josef S. Landewé, Robert B.M. Bergstra, Sytske Anne Kerschbaumer, Andreas Sepriano, Alexandre Aletaha, Daniel Caporali, Roberto Edwards, Christopher John Hyrich, Kimme L. Pope, Janet E. De Souza, Savia Stamm, Tanja A. Takeuchi, Tsutomu Verschueren, Patrick Winthrop, Kevin L. Balsa, Alejandro Bathon, Joan M. Buch, Maya H. Burmester, Gerd R. Buttgereit, Frank Cardiel, Mario Humberto Chatzidionysiou, Katerina Codreanu, Catalin Cutolo, Maurizio Den Broeder, Alfons A. El Aoufy, Khadija Finckh, Axel Fonseca, João Eurico Gottenberg, Jacques Eric Haavardsholm, Espen A. Iagnocco, Annamaria Lauper, Kim Li, Zhanguo McInnes, Iain B. Mysler, Eduardo F. Nash, Peter Poor, Gyula Ristic, Gorica G. Rivellese, Felice Rubbert-Roth, Andrea Schulze-Koops, Hendrik Stoilov, Nikolay Strangfeld, Anja Van Der Helm-Van Mil, Annette Van Duuren, Elsa Vliet Vlieland, Theodora P.M. Westhovens, René Van Der Heijde, Désirée Smolen, Josef S. |
| dc.subject.por.fl_str_mv |
Antirheumatic Agents Arthritis, Rheumatoid Biological Therapy Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| topic |
Antirheumatic Agents Arthritis, Rheumatoid Biological Therapy Rheumatology Immunology and Allergy Immunology Biochemistry, Genetics and Molecular Biology(all) |
| description |
Funding Information: This study was funded by European League Against Rheumatism. Publisher Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. |
| publishDate |
2022 |
| dc.date.none.fl_str_mv |
2022-11 2022-11-01T00:00:00Z 2023-01-11T22:18:02Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10362/147368 |
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eng |
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eng |
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0003-4967 PURE: 48346601 https://doi.org/10.1136/ard-2022-223356 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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