Odporúčania EULAR pre manažment reumatoidnej artritídy syntetickými a biologickými ochorenie modifikujúcimi antireumatickými liekmi: Aktualizácia 2013

Translated title of the contribution: EULAR recommendations for the managements of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 Update

J. S. Smolen, R. Landewé, F. C. Breedveld, M. Buch, G. Burmester, M. Dougados, P. Emery, C. Gaujoux-Viala, L. Gossec, J. Nam, S. Ramiro, K. Winthrop, M. De Wit, D. Aletaha, N. Betteridge, J. W.J. Bijlsma, M. Boers, F. Buttgereit, B. Combe, M. CutoloN. Damjanov, J. M.W. Hazes, M. Kouloumas, T. K. Kvien, X. Mariette, K. Pavelka, P. L.C.M. Van Riel, A. Rubbert-Roth, M. Scholte-Voshaar, D. L. Scott, T. Sokka-Isler, J. B. Wong, D. Van Der Heijde

Research output: Contribution to journalReview article

5 Scopus citations

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 6 months (or improvement not seen at 3 months). 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.

Translated title of the contributionEULAR recommendations for the managements of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 Update
Original languageSlovak
Pages (from-to)1-25
Number of pages25
JournalRheumatologia
Volume28
Issue number1
StatePublished - 2014

Keywords

  • Biological antirheumatic drugs
  • Disease-modifying antirheumatic drugs
  • EULAR recommendations
  • Managements of rheumatoid arthritis
  • Synthetic antirheumatic drugs

ASJC Scopus subject areas

  • Rheumatology

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  • Cite this

    Smolen, J. S., Landewé, R., Breedveld, F. C., Buch, M., Burmester, G., Dougados, M., Emery, P., Gaujoux-Viala, C., Gossec, L., Nam, J., Ramiro, S., Winthrop, K., De Wit, M., Aletaha, D., Betteridge, N., Bijlsma, J. W. J., Boers, M., Buttgereit, F., Combe, B., ... Van Der Heijde, D. (2014). Odporúčania EULAR pre manažment reumatoidnej artritídy syntetickými a biologickými ochorenie modifikujúcimi antireumatickými liekmi: Aktualizácia 2013. Rheumatologia, 28(1), 1-25.