EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs

Josef S. Smolen, Robert Landewé, Ferdinand C. Breedveld, Maxime Dougados, Paul Emery, Cecile Gaujoux-Viala, Simone Gorter, Rachel Knevel, Jackie Nam, Monika Schoels, Daniel Aletaha, Maya Buch, Laure Gossec, Tom Huizinga, Johannes W J W Bijlsma, Gerd Burmester, Bernard Combe, Maurizio Cutolo, Cem Gabay, Juan Gomez-ReinoMarios Kouloumas, Tore K. Kvien, Emilio Martin-Mola, Iain McInnes, Karel Pavelka, Piet Van Riel, Marieke Scholte, David L. Scott, Tuulikki Sokka, Guido Valesini, Ronald Van Vollenhoven, Kevin Winthrop, John Wong, Angela Zink, Désirée Van Der Heijde

Research output: Contribution to journalArticle

1193 Citations (Scopus)

Abstract

Treatment of rheumatoid arthritis (RA) may differ among rheumatologists and currently, clear and consensual international recommendations on RA treatment are not available. In this paper recommendations for the treatment of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects, are described. The recommendations are based on evidence from five systematic literature reviews (SLRs) performed for synthetic DMARDs, biological DMARDs, GCs, treatment strategies and economic issues. The SLR-derived evidence was discussed and summarised as an expert opinion in the course of a Delphi-like process. Levels of evidence, strength of recommendations and levels of agreement were derived. Fifteen recommendations were developed covering an area from general aspects such as remission/low disease activity as treatment aim via the preference for methotrexate monotherapy with or without GCs vis-à-vis combination of synthetic DMARDs to the use of biological agents mainly in patients for whom synthetic DMARDs and tumour necrosis factor inhibitors had failed. Cost effectiveness of the treatments was additionally examined. These recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA, based on evidence and expert opinion.

Original languageEnglish (US)
Pages (from-to)964-975
Number of pages12
JournalAnnals of the Rheumatic Diseases
Volume69
Issue number6
DOIs
StatePublished - Jun 2010

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Antirheumatic Agents
Rheumatoid Arthritis
Glucocorticoids
Expert Testimony
Therapeutics
Economics
Biological Factors
Cost effectiveness
Methotrexate
Cost-Benefit Analysis
Tumor Necrosis Factor-alpha

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Smolen, J. S., Landewé, R., Breedveld, F. C., Dougados, M., Emery, P., Gaujoux-Viala, C., ... Van Der Heijde, D. (2010). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Annals of the Rheumatic Diseases, 69(6), 964-975. https://doi.org/10.1136/ard.2009.126532

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. / Smolen, Josef S.; Landewé, Robert; Breedveld, Ferdinand C.; Dougados, Maxime; Emery, Paul; Gaujoux-Viala, Cecile; Gorter, Simone; Knevel, Rachel; Nam, Jackie; Schoels, Monika; Aletaha, Daniel; Buch, Maya; Gossec, Laure; Huizinga, Tom; Bijlsma, Johannes W J W; Burmester, Gerd; Combe, Bernard; Cutolo, Maurizio; Gabay, Cem; Gomez-Reino, Juan; Kouloumas, Marios; Kvien, Tore K.; Martin-Mola, Emilio; McInnes, Iain; Pavelka, Karel; Van Riel, Piet; Scholte, Marieke; Scott, David L.; Sokka, Tuulikki; Valesini, Guido; Van Vollenhoven, Ronald; Winthrop, Kevin; Wong, John; Zink, Angela; Van Der Heijde, Désirée.

In: Annals of the Rheumatic Diseases, Vol. 69, No. 6, 06.2010, p. 964-975.

Research output: Contribution to journalArticle

Smolen, JS, Landewé, R, Breedveld, FC, Dougados, M, Emery, P, Gaujoux-Viala, C, Gorter, S, Knevel, R, Nam, J, Schoels, M, Aletaha, D, Buch, M, Gossec, L, Huizinga, T, Bijlsma, JWJW, Burmester, G, Combe, B, Cutolo, M, Gabay, C, Gomez-Reino, J, Kouloumas, M, Kvien, TK, Martin-Mola, E, McInnes, I, Pavelka, K, Van Riel, P, Scholte, M, Scott, DL, Sokka, T, Valesini, G, Van Vollenhoven, R, Winthrop, K, Wong, J, Zink, A & Van Der Heijde, D 2010, 'EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs', Annals of the Rheumatic Diseases, vol. 69, no. 6, pp. 964-975. https://doi.org/10.1136/ard.2009.126532
Smolen, Josef S. ; Landewé, Robert ; Breedveld, Ferdinand C. ; Dougados, Maxime ; Emery, Paul ; Gaujoux-Viala, Cecile ; Gorter, Simone ; Knevel, Rachel ; Nam, Jackie ; Schoels, Monika ; Aletaha, Daniel ; Buch, Maya ; Gossec, Laure ; Huizinga, Tom ; Bijlsma, Johannes W J W ; Burmester, Gerd ; Combe, Bernard ; Cutolo, Maurizio ; Gabay, Cem ; Gomez-Reino, Juan ; Kouloumas, Marios ; Kvien, Tore K. ; Martin-Mola, Emilio ; McInnes, Iain ; Pavelka, Karel ; Van Riel, Piet ; Scholte, Marieke ; Scott, David L. ; Sokka, Tuulikki ; Valesini, Guido ; Van Vollenhoven, Ronald ; Winthrop, Kevin ; Wong, John ; Zink, Angela ; Van Der Heijde, Désirée. / EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. In: Annals of the Rheumatic Diseases. 2010 ; Vol. 69, No. 6. pp. 964-975.
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AU - Dougados, Maxime

AU - Emery, Paul

AU - Gaujoux-Viala, Cecile

AU - Gorter, Simone

AU - Knevel, Rachel

AU - Nam, Jackie

AU - Schoels, Monika

AU - Aletaha, Daniel

AU - Buch, Maya

AU - Gossec, Laure

AU - Huizinga, Tom

AU - Bijlsma, Johannes W J W

AU - Burmester, Gerd

AU - Combe, Bernard

AU - Cutolo, Maurizio

AU - Gabay, Cem

AU - Gomez-Reino, Juan

AU - Kouloumas, Marios

AU - Kvien, Tore K.

AU - Martin-Mola, Emilio

AU - McInnes, Iain

AU - Pavelka, Karel

AU - Van Riel, Piet

AU - Scholte, Marieke

AU - Scott, David L.

AU - Sokka, Tuulikki

AU - Valesini, Guido

AU - Van Vollenhoven, Ronald

AU - Winthrop, Kevin

AU - Wong, John

AU - Zink, Angela

AU - Van Der Heijde, Désirée

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