Canadian Rheumatology Association Recommendations for Pharmacological Management of Rheumatoid Arthritis with Traditional and Biologic Disease-modifying Antirheumatic Drugs

The Canadian Rheumatology Association (CRA) has developed recommendations for the pharmacological management of rheumatoid arthritis (RA) with traditional and biologic disease-modifying antirheumatic drugs (DMARD) in 2 parts. Part 1 is reported here. The CRA Therapeutics Committee assembled a nation...

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Bibliographic Details
Published in:Journal of rheumatology 2012-08, Vol.39 (8), p.1559-1582
Main Authors: BYKERK, Vivian P, AKHAVAN, Pooneh, PENCHARZ, James, POPE, Janet E, THOMSON, John, THORNE, Carter, ZUMMER, Michel, BOMBARDIER, Claire, HAZLEWOOD, Glen S, SCHIEIR, Orit, DOOLEY, Anne, HARAOUI, Boulos, KHRAISHI, Majed, LECLERCQ, Sharon A, LEGARE, Jean, MOSHER, Diane P
Format: Article
Language:English
Subjects:
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Biological and medical sciences
Bones, joints and connective tissue. Antiinflammatory agents
Canada
Consensus
Diseases of the osteoarticular system
Evidence-Based Medicine
Humans
Inflammatory joint diseases
Medical sciences
Pharmacology. Drug treatments
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Summary:The Canadian Rheumatology Association (CRA) has developed recommendations for the pharmacological management of rheumatoid arthritis (RA) with traditional and biologic disease-modifying antirheumatic drugs (DMARD) in 2 parts. Part 1 is reported here. The CRA Therapeutics Committee assembled a national working group of RA clinical experts, researchers, patient consumers, and a general practitioner. Treatment questions were developed a priori based on results of a national needs assessment survey. A systematic review of all clinical practice guidelines and consensus statements regarding treatment with traditional and biologic DMARD in patients with RA published between January 2000 and June 2010 was performed in Medline, Embase, and CINAHL databases, and the grey literature. Guideline quality was assessed by 2 independent reviewers, and guideline characteristics, recommendations, and supporting evidence from observational studies and randomized controlled trials were synthesized into evidence tables. The full working group reviewed the evidence tables and developed recommendations using a modified Delphi technique. Five overarching principles and 26 recommendations addressing general RA management strategies and treatment with glucocorticoids and traditional and biologic DMARD were developed for rheumatologists, other primary prescribers of RA drug therapies, and patients with RA. These recommendations were developed based on a synthesis of international guidelines, supporting evidence, and expert consensus considering the Canadian healthcare context with the intention of promoting best practices and improving healthcare delivery for persons with RA.
ISSN:0315-162X
1499-2752
DOI:10.3899/jrheum.110207