Обзорная статья

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis

Liana FraenkelBerkshire Medical Center, Pittsfield, Massachusetts, and Yale University School of Medicine New Haven Connecticut United StatesJoan M. BathonColumbia University Irving Medical Center New York Presbyterian Hospital New York New York United StatesBryant R. EnglandUniversity of Nebraska Medical Center and VA Nebraska–Western Iowa Health Care System Omaha Nebraska United StatesE. William St. ClairDuke University Medical Center Durham North Carolina United StatesThurayya ArayssiWeill Cornell Medicine–Qatar Doha QatarKristine CarandangUniversity of California San DiegoKevin D. DeaneUniversity of Colorado AuroraMark C. GenoveseStanford University Medical Center Palo Alto California United StatesK. HustonGail S. KerrVeterans Affairs Medical Center Georgetown and Howard University Washington DC United StatesJoel M. KremerAlbany Medical College and The Center for Rheumatology Albany New York United StatesMary C. NakamuraUniversity of California San FranciscoLinda RussellHospital for Special Surgery New York New York United StatesJasvinder A. SinghUniversity of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center Birmingham Alabama United StatesBenjamin J. SmithFlorida State University College of Medicine School of Physician Assistant Practice TallahasseeJeffrey A. SparksBrigham and Women’s Hospital and Harvard Medical School Boston Massachusetts United StatesShilpa VenkatachalamGlobal Healthy Living Foundation Upper Nyack New York United StatesMichael E. WeinblattBrigham and Women’s Hospital and Harvard Medical School Boston Massachusetts United StatesMounir Al‐GibbawiAmerican University of Beirut Beirut LebanonJoshua F. BakerCorporal Michael J. Crescenz VA Medical Center and the University of Pennsylvania Philadelphia Pennsylvania United StatesKamil E. BarbourCenters for Disease Control and Prevention Atlanta Georgia United StatesJennifer L. BartonOregon Health & Science University and VA Portland Health Care System Portland Oregon United StatesLaura C. CappelliJohns Hopkins Medicine Baltimore Maryland United StatesFatimah ChamseddineAmerican University of Beirut Beirut LebanonMichael GeorgeUniversity of Pennsylvania PhiladelphiaSindhu R. JohnsonToronto Western Hospital Mount Sinai Hospital Institute of Health Policy Management and Evaluation University of Toronto Toronto Ontario CanadaLara A KahaleAmerican University of Beirut Beirut LebanonBasil S. KaramAmerican University of Beirut Beirut LebanonAssem M. KhamisAmerican University of Beirut Beirut LebanonIris Navarro‐MillánWeill Cornell Medicine New York New York United StatesReza MirzaUniversity of Toronto Toronto Ontario CanadaPascale SchwabOregon Health & Science University and VA Portland Health Care System Portland Oregon United StatesNamrata SinghUniversity of Washington SeattleMarat TurgunbaevAmerican College of Rheumatology Atlanta Georgia United StatesAmy S. TurnerAmerican College of Rheumatology Atlanta Georgia United StatesSally YaacoubAmerican University of Beirut Beirut LebanonElie A. AklAmerican University of Beirut Beirut Lebanon

2021en

ABI

Аннотация

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.

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Идентификаторы

DOI: 10.1002/art.41752

Цитирования и источники

Цитирований: 2Использованных источников: 0

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