TY - JOUR
T1 - 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
AU - Fraenkel, Liana
AU - Bathon, Joan M.
AU - England, Bryant R.
AU - St.Clair, E. William
AU - Arayssi, Thurayya
AU - Carandang, Kristine
AU - Deane, Kevin D.
AU - Genovese, Mark
AU - Huston, Kent Kwas
AU - Kerr, Gail
AU - Kremer, Joel
AU - Nakamura, Mary C.
AU - Russell, Linda A.
AU - Singh, Jasvinder A.
AU - Smith, Benjamin J.
AU - Sparks, Jeffrey A.
AU - Venkatachalam, Shilpa
AU - Weinblatt, Michael E.
AU - Al-Gibbawi, Mounir
AU - Baker, Joshua F.
AU - Barbour, Kamil E.
AU - Barton, Jennifer L.
AU - Cappelli, Laura
AU - Chamseddine, Fatimah
AU - George, Michael
AU - Johnson, Sindhu R.
AU - Kahale, Lara
AU - Karam, Basil S.
AU - Khamis, Assem M.
AU - Navarro-Millán, Iris
AU - Mirza, Reza
AU - Schwab, Pascale
AU - Singh, Namrata
AU - Turgunbaev, Marat
AU - Turner, Amy S.
AU - Yaacoub, Sally
AU - Akl, Elie A.
N1 - Publisher Copyright:
© 2021, American College of Rheumatology
PY - 2021/7
Y1 - 2021/7
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85107805071
UR - https://www.scopus.com/pages/publications/85107805071#tab=citedBy
U2 - 10.1002/acr.24596
DO - 10.1002/acr.24596
M3 - Article
C2 - 34101387
AN - SCOPUS:85107805071
SN - 2151-464X
VL - 73
SP - 924
EP - 939
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 7
ER -