Worawit Louthrenoo1, Nuntana Kasitanon1, Wanruchada Katchamart2, Duangkamol Aiewruengsurat3, Parawee Chevaisrakul4, Praveena Chiowchanwisawakit2, Pornchai Dechanuwong5, Punchong Hanvivadhanakul6, Ajanee Mahakkanukrauh7, Siriporn Manavathongchai5, Chayawee Muangchan2, Pongthorn Narongroeknawin8, Veerapong Phumethum9, Boonjing Siripaitoon3, Anawat Suesuwan10, Siraphop Suwannaroj7, Parichat Uea-Areewongsa3, Sittichai Ukritchon11, Paijit Asavatanabodee12, Ajchara Koolvisoot2, Ratanavadee Nanagara7, Kitti Totemchokchyakarn4, Kanokrut Nuntirooj4, Tasanee Kitumnuaypong13. 1. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2. Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 3. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand. 4. Division of Allergy Immunology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 5. Department of Internal Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand. 6. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand. 7. Division of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. 8. Division of Rheumatology, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. 9. Division of Rheumatology, Department of Internal Medicine, Pha Pok Klao Hospital, Chanthaburi, Thailand. 10. Vibhavadi Hospital, Bangkok, Thailand. 11. Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 12. Rheumatic Disease Unit, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand. 13. Rheumatology Unit, Department of Medicine, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand.
Abstract
AIM: In June 2015, the Thai Rheumatism Association (TRA) approved an update of its recommendation for the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) and targeted synthetic (tsDMARD) in the treatment of rheumatoid arthritis (RA) to cover those currently available in Thailand (etanercept, infliximab, golimumab, rituximab, tocilizumab, abatacept and tofacitinib). METHOD: A search of the literature was performed between January 2000 and June 2015. Existing RA recommendations, in relation to the use of bDMARDs and tsDMARD, were identified and evaluated by the AGREE II instrument prior to their use as a 'guide' for developing this TRA recommendation. An additional literature search was performed in order to answer specific clinical questions that could not be found in existing guidelines. RESULT: Thirteen recommendations were developed. They covered the use of RA classification criteria, the aim of RA treatment, when to initiate bDMARDs/tsDMARD or taper or switch them to other medications, as well as monitoring these drugs during their use. In addition, specific issues including their use and vaccination, malignancies, pregnancy and lactation, and perioperative period also were addressed. Public hearings were performed at the annual meeting of the TRA and of the Royal College of Physicians of Thailand. The recommendations were distributed to other professional associations related to RA management, as well as government sectors associated with the reimbursement policy, prior to development of the final version. CONCLUSION: These recommendations will help Thai rheumatologists prescribe bDMARDs and tsDMARD more appropriately when treating RA patients.
AIM: In June 2015, the Thai Rheumatism Association (TRA) approved an update of its recommendation for the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) and targeted synthetic (tsDMARD) in the treatment of rheumatoid arthritis (RA) to cover those currently available in Thailand (etanercept, infliximab, golimumab, rituximab, tocilizumab, abatacept and tofacitinib). METHOD: A search of the literature was performed between January 2000 and June 2015. Existing RA recommendations, in relation to the use of bDMARDs and tsDMARD, were identified and evaluated by the AGREE II instrument prior to their use as a 'guide' for developing this TRA recommendation. An additional literature search was performed in order to answer specific clinical questions that could not be found in existing guidelines. RESULT: Thirteen recommendations were developed. They covered the use of RA classification criteria, the aim of RA treatment, when to initiate bDMARDs/tsDMARD or taper or switch them to other medications, as well as monitoring these drugs during their use. In addition, specific issues including their use and vaccination, malignancies, pregnancy and lactation, and perioperative period also were addressed. Public hearings were performed at the annual meeting of the TRA and of the Royal College of Physicians of Thailand. The recommendations were distributed to other professional associations related to RA management, as well as government sectors associated with the reimbursement policy, prior to development of the final version. CONCLUSION: These recommendations will help Thai rheumatologists prescribe bDMARDs and tsDMARD more appropriately when treating RA patients.
Authors: Laura Lorena Castiblanco; María Jesús García de Yébenes; Jose María Martín Martín; Loreto Carmona Journal: Rheumatol Int Date: 2022-08-18 Impact factor: 3.580