TY - JOUR
T1 - Treating rheumatoid arthritis to target
T2 - Recommendations of an international task force
AU - Smolen, Josef S.
AU - Aletaha, Daniel
AU - Bijlsma, Johannes W J
AU - Breedveld, Ferdinand C.
AU - Boumpas, Dimitrios
AU - Burmester, Gerd
AU - Combe, Bernard
AU - Cutolo, Maurizio
AU - De Wit, Maarten
AU - Dougados, Maxime
AU - Emery, Paul
AU - Gibofsky, Alan
AU - Gomez-Reino, Juan Jesus
AU - Haraoui, Boulos
AU - Kalden, Joachim
AU - Keystone, Edward C.
AU - Kvien, Tore K.
AU - McInnes, Iain
AU - Martin-Mola, Emilio
AU - Montecucco, Carlomaurizio
AU - Schoels, Monika
AU - Van Der Heijde, Desirée
PY - 2010/4
Y1 - 2010/4
N2 - 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.
AB - 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.
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U2 - 10.1136/ard.2009.123919
DO - 10.1136/ard.2009.123919
M3 - Article
C2 - 20215140
AN - SCOPUS:77950307115
VL - 69
SP - 631
EP - 637
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
IS - 4
ER -