Smolen, Josef S., Landewe, Robert, Breedveld, Ferdinand C., Buch, Maya ORCID: 0000-0002-8962-5642, Burmester, Gerd, Dougados, Maxime, Emery, Paul, Gaujoux-Viala, Cecile ORCID: 0000-0002-2099-6496, Gossec, Laure, Nam, Jackie, Ramiro, Sofia, Winthrop, Kevin, de Wit, Maarten, Aletaha, Daniel, Betteridge, Neil, Bijlsma, Johannes W. J., Boers, Maarten, Buttgereit, Frank ORCID: 0000-0003-2534-550X, Combe, Bernard, Cutolo, Maurizio, Damjanov, Nemanja, Hazes, Johanna M. W., Kouloumas, Marios, Kvien, Tore K., Mariette, Xavier, Pavelka, Karel ORCID: 0000-0003-1952-8422, van Riel, Piet L. C. M., Rubbert-Roth, Andrea, Scholte-Voshaar, Marieke, Scott, David L., Sokka-Isler, Tuulikki, Wong, John B. and van der Heijde, Desiree ORCID: 0000-0002-5781-158X (2014). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann. Rheum. Dis., 73 (3). S. 492 - 510. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2060

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Abstract

In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6months (or improvement not seen at 3months). Tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, biosimilars), abatacept, tocilizumab and, under certain circumstances, rituximab are essentially considered to have similar efficacy and safety. If the first bDMARD strategy fails, any other bDMARD may be used. The recommendations also address tofacitinib as a targeted sDMARD (tsDMARD), which is recommended, where licensed, after use of at least one bDMARD. Biosimilars are also addressed. These recommendations are intended to inform rheumatologists, patients, national rheumatology societies and other stakeholders about EULAR's most recent consensus on the management of RA with sDMARDs, glucocorticoids and bDMARDs. They are based on evidence and expert opinion and intended to improve outcome in patients with RA.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Smolen, Josef S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landewe, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Breedveld, Ferdinand C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buch, MayaUNSPECIFIEDorcid.org/0000-0002-8962-5642UNSPECIFIED
Burmester, GerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dougados, MaximeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Emery, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gaujoux-Viala, CecileUNSPECIFIEDorcid.org/0000-0002-2099-6496UNSPECIFIED
Gossec, LaureUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nam, JackieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ramiro, SofiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Winthrop, KevinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Wit, MaartenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aletaha, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Betteridge, NeilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bijlsma, Johannes W. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boers, MaartenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buttgereit, FrankUNSPECIFIEDorcid.org/0000-0003-2534-550XUNSPECIFIED
Combe, BernardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cutolo, MaurizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Damjanov, NemanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hazes, Johanna M. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kouloumas, MariosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kvien, Tore K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mariette, XavierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pavelka, KarelUNSPECIFIEDorcid.org/0000-0003-1952-8422UNSPECIFIED
van Riel, Piet L. C. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rubbert-Roth, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholte-Voshaar, MariekeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scott, David L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sokka-Isler, TuulikkiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wong, John B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Heijde, DesireeUNSPECIFIEDorcid.org/0000-0002-5781-158XUNSPECIFIED
URN: urn:nbn:de:hbz:38-445090
DOI: 10.1136/annrheumdis-2013-204573
Journal or Publication Title: Ann. Rheum. Dis.
Volume: 73
Number: 3
Page Range: S. 492 - 510
Date: 2014
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1468-2060
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ADALIMUMAB PLUS METHOTREXATE; RAPID RADIOGRAPHIC PROGRESSION; LOW-DOSE PREDNISOLONE; DOUBLE-BLIND; COMBINATION THERAPY; JOINT DAMAGE; TREATMENT STRATEGIES; INADEQUATE RESPONSE; PARALLEL-GROUP; FOLLOW-UPMultiple languages
RheumatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44509

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