Liana Fraenkel1, Joan M Bathon2, Bryant R England3, E William St Clair4, Thurayya Arayssi5, Kristine Carandang6, Kevin D Deane7, Mark Genovese8, Kent Kwas Huston9, Gail Kerr10, Joel Kremer11, Mary C Nakamura12, Linda A Russell13, Jasvinder A Singh14, Benjamin J Smith15, Jeffrey A Sparks16, Shilpa Venkatachalam17, Michael E Weinblatt16, Mounir Al-Gibbawi18, Joshua F Baker19, Kamil E Barbour20, Jennifer L Barton21, Laura Cappelli22, Fatimah Chamseddine18, Michael George23, Sindhu R Johnson24, Lara Kahale18, Basil S Karam18, Assem M Khamis18, Iris Navarro-Millán25, Reza Mirza26, Pascale Schwab21, Namrata Singh27, Marat Turgunbaev28, Amy S Turner28, Sally Yaacoub18, Elie A Akl18. 1. Berkshire Medical Center, Pittsfield, Massachusetts, and Yale University School of Medicine, New Haven, Connecticut, United States. 2. Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, United States. 3. University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, United States. 4. Duke University Medical Center, Durham, North Carolina, United States. 5. Weill Cornell Medicine-Qatar, Doha, Qatar. 6. University of California, San Diego. 7. University of Colorado, Aurora. 8. Stanford University Medical Center, Palo Alto, California, United States. 9. The Center for Rheumatic Disease/Allergy and Immunology, Kansas City, Missouri, United States. 10. Veterans Affairs Medical Center, Georgetown and Howard University, Washington, DC, United States. 11. Albany Medical College and The Center for Rheumatology, Albany, New York, United States. 12. University of California, San Francisco. 13. Hospital for Special Surgery, New York, New York, United States. 14. University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, United States. 15. Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. 16. Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States. 17. Global Healthy Living Foundation, Upper Nyack, New York, United States. 18. American University of Beirut, Beirut, Lebanon. 19. Corporal Michael J. Crescenz VA Medical Center and the University of Pennsylvania, Philadelphia, Pennsylvania, United States. 20. Centers for Disease Control and Prevention, Atlanta, Georgia, United States. 21. Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon, United States. 22. Johns Hopkins Medicine, Baltimore, Maryland, United States. 23. University of Pennsylvania, Philadelphia. 24. Toronto Western Hospital, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. 25. Weill Cornell Medicine, New York, New York, United States. 26. University of Toronto, Toronto, Ontario, Canada. 27. University of Washington, Seattle. 28. American College of Rheumatology, Atlanta, Georgia, United States.
Abstract
OBJECTIVE: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis. METHODS: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence. A voting panel comprising clinicians and patients achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS: The guideline addresses treatment with disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs, biologic DMARDs, and targeted synthetic DMARDs, use of glucocorticoids, and use of DMARDs in certain high-risk populations (i.e., those with liver disease, heart failure, lymphoproliferative disorders, previous serious infections, and nontuberculous mycobacterial lung disease). The guideline includes 44 recommendations (7 strong and 37 conditional). CONCLUSION: This clinical practice guideline is intended to serve as a tool to support clinician and patient decision-making. Recommendations are not prescriptive, and individual treatment decisions should be made through a shared decision-making process based on patients' values, goals, preferences, and comorbidities.
OBJECTIVE: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis. METHODS: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence. A voting panel comprising clinicians and patients achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS: The guideline addresses treatment with disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs, biologic DMARDs, and targeted synthetic DMARDs, use of glucocorticoids, and use of DMARDs in certain high-risk populations (i.e., those with liver disease, heart failure, lymphoproliferative disorders, previous serious infections, and nontuberculous mycobacterial lung disease). The guideline includes 44 recommendations (7 strong and 37 conditional). CONCLUSION: This clinical practice guideline is intended to serve as a tool to support clinician and patient decision-making. Recommendations are not prescriptive, and individual treatment decisions should be made through a shared decision-making process based on patients' values, goals, preferences, and comorbidities.
Authors: Katherine D Wysham; Jane Shofer; Gabriella Lui; Laura Trupin; James S Andrews; Dennis M Black; Jonathan Graf; Dolores M Shoback; Patricia P Katz Journal: Semin Arthritis Rheum Date: 2022-01-31 Impact factor: 5.532
Authors: Kyle Hayes; Mary P Panaccio; Parul Houston; John Niewoehner; Mohammed Fahim; George J Wan; Bhavna Dhillon Journal: Open Access Rheumatol Date: 2021-10-15
Authors: Angie Ariza-Hutchinson; Rosemina A Patel; N Suzanne Emil; Maheswari Muruganandam; Sharon E Nunez; Matthew K McElwee; Frank X O'Sullivan; Roderick A Fields; William A Hayward; Luke J Haseler; Wilmer L Sibbitt Journal: J Clin Aesthet Dermatol Date: 2022-08