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

• Autor(a) principal: Pereira, Ivânio Alves
• Data de Publicação: 2012
• Outros Autores: 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 Antonio da, Louzada Junior, Paulo, Giorgi, Rina Dalva Neubarth, Lima, Rodrigo Aires Corrêa, Bonfá, Eloisa Silva Dutra de Oliveira, Pinheiro, Geraldo da Rocha Castelar
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/147019
• topic: Artrite reumatóide; Comorbidade; Diabetes mellitus; Dislipidemias; Consenso; Rheumatoid arthritis; Comorbidities; Arterial hypertension; Diabetes mellitus; Dyslipidemia

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. Results and conclusions: Recommendations: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specifi c 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.