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Treating rheumatoid arthritis to target : 2014 update of the recommendations of an international task force

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dc.contributor.authorSmolen, Josef S.
dc.contributor.authorBreedveld, Ferdinand C.
dc.contributor.authorBurmester, Gerd R.
dc.contributor.authorBykerk, Vivian
dc.contributor.authorDougados, Maxime
dc.contributor.authorEmery, Paul
dc.contributor.authorKvien, Tore K.
dc.contributor.authorNavarro-Compán, M Victoria
dc.contributor.authorOliver, Susan
dc.contributor.authorSchoels, Monika
dc.contributor.authorScholte-Voshaar, Marieke
dc.contributor.authorStamm, Tanja
dc.contributor.authorStoffer, Michaela
dc.contributor.authorTakeuchi, Tsutomu
dc.contributor.authorAletaha, Daniel
dc.contributor.authorAndreu, Jose Louis
dc.contributor.authorAringer, Martin
dc.contributor.authorBergman, Martin
dc.contributor.authorBetteridge, Neil
dc.contributor.authorBijlsma, Hans
dc.contributor.authorBurkhardt, Harald
dc.contributor.authorCardiel, Mario
dc.contributor.authorCombe, Bernard
dc.contributor.authorDurez, Patrick
dc.contributor.authorFonseca, João Eurico
dc.contributor.authorGibofsky, Alan
dc.contributor.authorGomez-Reino, Juan J.
dc.contributor.authorGraninger, Winfried
dc.contributor.authorHannonen, Pekka
dc.contributor.authorHaraoui, Boulos
dc.contributor.authorKouloumas, Marios
dc.contributor.authorLandewe, Robert
dc.contributor.authorMartin-Mola, Emilio
dc.contributor.authorNash, Peter
dc.contributor.authorOstergaard, Mikkel
dc.contributor.authorÖstör, Andrew
dc.contributor.authorRichards, Pam
dc.contributor.authorSokka-Isler, Tuulikki
dc.contributor.authorThorne, Carter
dc.contributor.authorTzioufas, Athanasios G.
dc.contributor.authorvan Vollenhoven, Ronald
dc.contributor.authorde Wit, Martinus
dc.contributor.authorvan der Heijde, Desirée
dc.date.accessioned2021-03-10T12:32:59Z
dc.date.available2021-03-10T12:32:59Z
dc.date.issued2016
dc.descriptionThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.description.abstractBackground: Reaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this therapeutic goal in routine clinical practice, but these recommendations need to be re-evaluated for appropriateness and practicability in the light of new insights. Objective: To update the 2010 treat-to-target recommendations based on systematic literature reviews (SLR) and expert opinion. Methods: A task force of rheumatologists, patients and a nurse specialist assessed the SLR results and evaluated the individual items of the 2010 recommendations accordingly, reformulating many of the items. These were subsequently discussed, amended and voted upon by >40 experts, including 5 patients, from various regions of the world. Levels of evidence, strengths of recommendations and levels of agreement were derived. Results: The update resulted in 4 overarching principles and 10 recommendations. The previous recommendations were partly adapted and their order changed as deemed appropriate in terms of importance in the view of the experts. The SLR had now provided also data for the effectiveness of targeting low-disease activity or remission in established rather than only early disease. The role of comorbidities, including their potential to preclude treatment intensification, was highlighted more strongly than before. The treatment aim was again defined as remission with low-disease activity being an alternative goal especially in patients with long-standing disease. Regular follow-up (every 1-3 months during active disease) with according therapeutic adaptations to reach the desired state was recommended. Follow-up examinations ought to employ composite measures of disease activity that include joint counts. Additional items provide further details for particular aspects of the disease, especially comorbidity and shared decision-making with the patient. Levels of evidence had increased for many items compared with the 2010 recommendations, and levels of agreement were very high for most of the individual recommendations (≥9/10). Conclusions: The 4 overarching principles and 10 recommendations are based on stronger evidence than before and are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Rheum Dis. 2016 Jan;75(1):3-15pt_PT
dc.identifier.doi10.1136/annrheumdis-2015-207524pt_PT
dc.identifier.eissn1468-2060
dc.identifier.issn0003-4967
dc.identifier.urihttp://hdl.handle.net/10451/46769
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Group Ltd.pt_PT
dc.relation.publisherversionhttps://ard.bmj.com/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectDisease activitypt_PT
dc.subjectEarly rheumatoid arthritispt_PT
dc.subjectOutcomes researchpt_PT
dc.subjectRheumatoid arthritispt_PT
dc.subjectTreatmentpt_PT
dc.titleTreating rheumatoid arthritis to target : 2014 update of the recommendations of an international task forcept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage15pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage3pt_PT
oaire.citation.titleAnnals of the Rheumatic Diseasespt_PT
oaire.citation.volume75pt_PT
person.familyNameFonseca
person.givenNameJoão
person.identifier.ciencia-idF310-B85D-57C7
person.identifier.orcid0000-0003-1432-3671
person.identifier.scopus-author-id7101983519
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication1772dc12-7c55-4c76-ae2d-c23270172480
relation.isAuthorOfPublication.latestForDiscovery1772dc12-7c55-4c76-ae2d-c23270172480

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IMM - Artigos em Revistas Internacionais