Treating rheumatoid arthritis to target: recommendations of an international task force

被引：1592

作者：

Smolen, Josef S. ^{[1
,2
]}

Aletaha, Daniel ^{[1
]}

Bijlsma, Johannes W. J. ^{[3
]}

Breedveld, Ferdinand C. ^{[4
]}

Boumpas, Dimitrios ^{[5
]}

Burmester, Gerd ^{[6
]}

Combe, Bernard ^{[7
]}

Cutolo, Maurizio ^{[8
,9
]}

de Wit, Maarten ^{[10
]}

Dougados, Maxime ^{[11
]}

Emery, Paul ^{[12
]}

Gibofsky, Alan ^{[13
]}

Gomez-Reino, Juan Jesus ^{[14
]}

Haraoui, Boulos ^{[15
]}

Kalden, Joachim ^{[16
]}

Keystone, Edward C. ^{[17
]}

Kvien, Tore K. ^{[18
]}

McInnes, Iain ^{[19
]}

Martin-Mola, Emilio ^{[20
]}

Montecucco, Carlomaurizio ^{[21
]}

Schoels, Monika ^{[2
]}

van der Heijde, Desiree ^{[4
]}

机构：

[1] Med Univ Vienna, Div Rheumatol, Dept Internal Med 3, A-1090 Vienna, Austria

[2] Hietzing Hosp, Ctr Rheumat Dis, Dept Med 2, Vienna, Austria

[3] Univ Med Ctr Utrecht, Dept Rheumatol & Clin Immunol, Utrecht, Netherlands

[4] Leiden Univ, Med Ctr, Dept Rheumatol, Leiden, Netherlands

[5] Univ Crete, Fac Med, Dept Med, Iraklion, Greece

[6] Humboldt Univ, Dept Rheumatol & Clin Immunol, Charite Hosp, Berlin, Germany

[7] Univ Montpellier, Lapeyronie Hosp, Serv Immunorhumatol, F-34059 Montpellier, France

[8] Univ Genoa, Dept Internal Med, Res Lab, I-16126 Genoa, Italy

[9] Univ Genoa, Dept Internal Med, Acad Clin Unit Rheumatol, I-16126 Genoa, Italy

[10] EULAR Standing Comm People Arthrit Rheumatism Eur, Zurich, Switzerland

[11] Univ Paris 05, Cochin Hosp, Dept Rheumatol B, Paris, France

[12] Univ Leeds, Acad Unit Musculoskeletal Dis, Leeds, W Yorkshire, England

[13] Cornell Univ, Hosp Special Surg, Weill Med Coll, New York, NY 10021 USA

[14] Univ Santiago, Clin Hosp, NEIRID Lab, Santiago De Compostela, Spain

[15] Inst Rhumatol Montreal, Montreal, PQ, Canada

[16] Univ Erlangen Nurnberg, Fiebiger Ctr, Erlangen, Germany

[17] Univ Toronto, Toronto, ON, Canada

[18] Diakonhjemmet Hosp, Dept Rheumatol, Oslo, Norway

[19] Univ Glasgow, Glasgow, Lanark, Scotland

[20] Hosp La Paz, Madrid, Spain

[21] Univ Pavia, Policlin San Matteo, IRCCS, Dept Rheumatol, I-27100 Pavia, Italy

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2010年 / 69卷 / 04期

关键词：

REPORTING DISEASE-ACTIVITY; C-REACTIVE PROTEIN; EULAR/ACR COLLABORATIVE RECOMMENDATIONS; MODIFYING ANTIRHEUMATIC DRUGS; RANDOMIZED CONTROLLED-TRIAL; CLINICAL-TRIALS; RADIOLOGIC DAMAGE; FOLLOW-UP; METHOTREXATE MONOTHERAPY; TREATMENT STRATEGIES;

D O I：

10.1136/ard.2009.123919

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Aiming at therapeutic targets has reduced the risk of organ failure in many diseases such as diabetes or hypertension. Such targets have not been defined for rheumatoid arthritis (RA). Objective To develop recommendations for achieving optimal therapeutic outcomes in RA. Methods A task force of rheumatologists and a patient developed a set of recommendations on the basis of evidence derived from a systematic literature review and expert opinion; these were subsequently discussed, amended and voted upon by >60 experts from various regions of the world in a Delphi-like procedure. Levels of evidence, strength of recommendations and levels of agreement were derived. Results The treat-to-target activity resulted in 10 recommendations. The treatment aim was defined as remission with low disease activity being an alternative goal in patients with long-standing disease. Regular follow-up (every 1-3 months during active disease) with appropriate therapeutic adaptation to reach the desired state within 3 to a maximum of 6 months was recommended. Follow-up examinations ought to employ composite measures of disease activity which include joint counts. Additional items provide further details for particular aspects of the disease. Levels of agreement were very high for many of these recommendations (>= 9/10). Conclusion The 10 recommendations are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA based on evidence and expert opinion.

引用

页码：631 / 637

页数：7

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