EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs.

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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs.
Smolen, Josef S; Landewé, Robert; Breedveld, Ferdinand C; Dougados, Maxime; Emery, Paul; Gaujoux-Viala, Cecile; Gorter, Simone; Knevel, Rachel; Nam, Jackie; Schoels, Monika; Aletaha, Daniel; Buch, Maya; Gossec, Laure; Huizinga, Tom; Bijlsma, Johannes W J W; Burmester, Gerd; Combe, Bernard; Cutolo, Maurizio; Gabay, Cem; Gomez-Reino, Juan; Kouloumas, Marios; Kvien, Tore K; Martin-Mola, Emilio; McInnes, Iain; Pavelka, Karel; van Riel, Piet; Scholte, Marieke; Scott, David L; Sokka, Tuulikki; Valesini, Guido; van Vollenhoven, Ronald; Winthrop, Kevin L; Wong, John; Zink, Angela; van der Heijde, Désirée
Annals of the rheumatic diseases 2010, 69 (6):964-75
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dc.contributor.authorSmolen, Josef Sen
dc.contributor.authorLandewé, Roberten
dc.contributor.authorBreedveld, Ferdinand Cen
dc.contributor.authorDougados, Maximeen
dc.contributor.authorEmery, Paulen
dc.contributor.authorGaujoux-Viala, Cecileen
dc.contributor.authorGorter, Simoneen
dc.contributor.authorKnevel, Rachelen
dc.contributor.authorNam, Jackieen
dc.contributor.authorSchoels, Monikaen
dc.contributor.authorAletaha, Danielen
dc.contributor.authorBuch, Mayaen
dc.contributor.authorGossec, Laureen
dc.contributor.authorHuizinga, Tomen
dc.contributor.authorBijlsma, Johannes W J Wen
dc.contributor.authorBurmester, Gerden
dc.contributor.authorCombe, Bernarden
dc.contributor.authorCutolo, Maurizioen
dc.contributor.authorGabay, Cemen
dc.contributor.authorGomez-Reino, Juanen
dc.contributor.authorKouloumas, Mariosen
dc.contributor.authorKvien, Tore Ken
dc.contributor.authorMartin-Mola, Emilioen
dc.contributor.authorMcInnes, Iainen
dc.contributor.authorPavelka, Karelen
dc.contributor.authorvan Riel, Pieten
dc.contributor.authorScholte, Mariekeen
dc.contributor.authorScott, David Len
dc.contributor.authorSokka, Tuulikkien
dc.contributor.authorValesini, Guidoen
dc.contributor.authorvan Vollenhoven, Ronalden
dc.contributor.authorWinthrop, Kevin Len
dc.contributor.authorWong, Johnen
dc.contributor.authorZink, Angelaen
dc.contributor.authorvan der Heijde, Désiréeen
dc.identifier.citationAnnals of the rheumatic diseases 2010, 69 (6):964-75en
dc.description.abstractTreatment of rheumatoid arthritis (RA) may differ among rheumatologists and currently, clear and consensual international recommendations on RA treatment are not available. In this paper recommendations for the treatment of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects, are described. The recommendations are based on evidence from five systematic literature reviews (SLRs) performed for synthetic DMARDs, biological DMARDs, GCs, treatment strategies and economic issues. The SLR-derived evidence was discussed and summarised as an expert opinion in the course of a Delphi-like process. Levels of evidence, strength of recommendations and levels of agreement were derived. Fifteen recommendations were developed covering an area from general aspects such as remission/low disease activity as treatment aim via the preference for methotrexate monotherapy with or without GCs vis-à-vis combination of synthetic DMARDs to the use of biological agents mainly in patients for whom synthetic DMARDs and tumour necrosis factor inhibitors had failed. Cost effectiveness of the treatments was additionally examined. These recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA, based on evidence and expert opinion.en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Reumatologi: 759en
dc.subject.meshAntirheumatic Agentsen
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshCost-Benefit Analysisen
dc.subject.meshEvidence-Based Medicineen
dc.subject.meshImmunosuppressive Agentsen
dc.subject.meshTumor Necrosis Factor-alphaen
dc.titleEULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. josef.smolen@wienkav.aten
dc.identifier.journalAnnals of the rheumatic diseasesen
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