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

By J. Smolen, Daniel Aletaha, J. Bijlsma, F. Breedveld, D. Boumpas, G. Burmester, B. Combe, M. Cutolo, Maarten de Wit, M. Dougados and 12 more. Annals of the Rheumatic Diseases, 2010

2,111 citations recorded by the source corpus.

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.

Subfields: Rehabilitation, Rheumatology

View Paper: https://www.semanticscholar.org/paper/0ba934f19ddef7cae6920c5658d978f71a7e5656

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In Rheumatology

1. Daniel Aletaha
2. J. Smolen
3. I. McInnes
4. S. Gaffen

Citations in the corpus

• EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update (2013, background): “Currently, data are available for one biosimilar in fl iximab poduct 115 which shows similar ef fi cacy and safety pro fi les to the original biological agent and was placed alongside the other TNF inhibitors in the therapeutic cascade; it is assumed that the price of this biosimilar will be signi fi…”
• Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force (2015, background): “19 21 There are several reasons to reconsider the treat-to-target recommendations.”
• EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update (2010, positive): “Thus, remission is the primary therapeutic aim, especially in early RA, though low disease activity may be an appropriate alternative, especially in patients with longstanding RA, as was also concluded by an expert committee recently engaged in defining a treatment target for RA.”