학술논문
2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.
Document Type
Academic Journal
Author
Fraenkel L; Berkshire Medical Center, Pittsfield, Massachusetts, and Yale University School of Medicine, New Haven, Connecticut, United States.; Bathon JM; Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, United States.; England BR; University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, United States.; St Clair EW; Duke University Medical Center, Durham, North Carolina, United States.; Arayssi T; Weill Cornell Medicine-Qatar, Doha, Qatar.; Carandang K; University of California, San Diego.; Deane KD; University of Colorado, Aurora.; Genovese M; Stanford University Medical Center, Palo Alto, California, United States.; Huston KK; The Center for Rheumatic Disease/Allergy and Immunology, Kansas City, Missouri, United States.; Kerr G; Veterans Affairs Medical Center, Georgetown and Howard University, Washington, DC, United States.; Kremer J; Albany Medical College and The Center for Rheumatology, Albany, New York, United States.; Nakamura MC; University of California, San Francisco.; Russell LA; Hospital for Special Surgery, New York, New York, United States.; Singh JA; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, United States.; Smith BJ; Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee.; Sparks JA; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States.; Venkatachalam S; Global Healthy Living Foundation, Upper Nyack, New York, United States.; Weinblatt ME; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States.; Al-Gibbawi M; American University of Beirut, Beirut, Lebanon.; Baker JF; Corporal Michael J. Crescenz VA Medical Center and the University of Pennsylvania, Philadelphia, Pennsylvania, United States.; Barbour KE; Centers for Disease Control and Prevention, Atlanta, Georgia, United States.; Barton JL; Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon, United States.; Cappelli L; Johns Hopkins Medicine, Baltimore, Maryland, United States.; Chamseddine F; American University of Beirut, Beirut, Lebanon.; George M; University of Pennsylvania, Philadelphia.; Johnson SR; Toronto Western Hospital, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.; Kahale L; American University of Beirut, Beirut, Lebanon.; Karam BS; American University of Beirut, Beirut, Lebanon.; Khamis AM; American University of Beirut, Beirut, Lebanon.; Navarro-Millán I; Weill Cornell Medicine, New York, New York, United States.; Mirza R; University of Toronto, Toronto, Ontario, Canada.; Schwab P; Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon, United States.; Singh N; University of Washington, Seattle.; Turgunbaev M; American College of Rheumatology, Atlanta, Georgia, United States.; Turner AS; American College of Rheumatology, Atlanta, Georgia, United States.; Yaacoub S; American University of Beirut, Beirut, Lebanon.; Akl EA; American University of Beirut, Beirut, Lebanon.
Source
Publisher: Wiley Country of Publication: United States NLM ID: 101623795 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2326-5205 (Electronic) Linking ISSN: 23265191 NLM ISO Abbreviation: Arthritis Rheumatol Subsets: MEDLINE
Subject
Language
English
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.
(© 2021, American College of Rheumatology.)
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.
(© 2021, American College of Rheumatology.)