Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology
Identifieur interne : 000F42 ( Istex/Corpus ); précédent : 000F41; suivant : 000F43Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology
Auteurs : Chi Chiu Mok ; Lai Shan Tam ; Tak Hin Chan ; Gavin K. W. Lee ; Edmund K. M. LiSource :
- Clinical Rheumatology [ 0770-3198 ] ; 2011-03-01.
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Abstract
Abstract: Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy.
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DOI: 10.1007/s10067-010-1596-y
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The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. 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The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. 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CorrespondingAffiliationID="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Chi</GivenName><GivenName>Chiu</GivenName><FamilyName>Mok</FamilyName></AuthorName><Contact><Phone>+852-2468-5386</Phone><Fax>+852-2456-9100</Fax><Email>ccmok2005@yahoo.com</Email></Contact></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Lai</GivenName><GivenName>Shan</GivenName><FamilyName>Tam</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff3"><AuthorName DisplayOrder="Western"><GivenName>Tak</GivenName><GivenName>Hin</GivenName><FamilyName>Chan</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff4"><AuthorName DisplayOrder="Western"><GivenName>Gavin</GivenName><GivenName>K.</GivenName><GivenName>W.</GivenName><FamilyName>Lee</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Edmund</GivenName><GivenName>K.</GivenName><GivenName>M.</GivenName><FamilyName>Li</FamilyName></AuthorName></Author><InstitutionalAuthor><InstitutionalAuthorName>Hong Kong Society of Rheumatology</InstitutionalAuthorName></InstitutionalAuthor><Affiliation ID="Aff1"><OrgDivision>Department of Medicine</OrgDivision><OrgName>Tuen Mun Hospital</OrgName><OrgAddress><City>Tuen Mun</City><Country Code="HK">Hong Kong</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Department of Medicine & Therapeutics, The Chinese University of Hong Kong</OrgDivision><OrgName>Prince of Wales Hospital</OrgName><OrgAddress><City>Sha Tin</City><Country Code="HK">Hong Kong</Country></OrgAddress></Affiliation><Affiliation ID="Aff3"><OrgName>Private practice</OrgName><OrgAddress><City>Admiralty</City><Country Code="HK">Hong Kong</Country></OrgAddress></Affiliation><Affiliation ID="Aff4"><OrgDivision>Department of Medicine</OrgDivision><OrgName>Union Hospital</OrgName><OrgAddress><City>Sha Tin</City><Country Code="HK">Hong Kong</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading><Para>Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy.</Para></Abstract><KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading><Keyword>Hong Kong</Keyword><Keyword>Management</Keyword><Keyword>Recommendations</Keyword><Keyword>Rheumatoid arthritis</Keyword></KeywordGroup></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology</title></titleInfo><name type="corporate"><namePart>Hong Kong Society of Rheumatology</namePart></name><name type="personal" displayLabel="corresp"><namePart type="given">Chi</namePart><namePart type="given">Chiu</namePart><namePart type="family">Mok</namePart><affiliation>Department of Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong</affiliation><affiliation>E-mail: ccmok2005@yahoo.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lai</namePart><namePart type="given">Shan</namePart><namePart type="family">Tam</namePart><affiliation>Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tak</namePart><namePart type="given">Hin</namePart><namePart type="family">Chan</namePart><affiliation>Private practice, Admiralty, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gavin</namePart><namePart type="given">K.</namePart><namePart type="given">W.</namePart><namePart type="family">Lee</namePart><affiliation>Department of Medicine, Union Hospital, Sha Tin, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Edmund</namePart><namePart type="given">K.</namePart><namePart type="given">M.</namePart><namePart type="family">Li</namePart><affiliation>Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="ReviewPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-L5L7X3NF-P">review-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">London</placeTerm></place><dateCreated encoding="w3cdtf">2010-09-29</dateCreated><dateIssued encoding="w3cdtf">2011-03-01</dateIssued><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy.</abstract><note>Review Article</note><subject lang="en"><genre>Keywords</genre><topic>Hong Kong</topic><topic>Management</topic><topic>Recommendations</topic><topic>Rheumatoid arthritis</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Rheumatology</title><subTitle>Journal of the International League of Associations for Rheumatology</subTitle></titleInfo><titleInfo type="abbreviated"><title>Clin Rheumatol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2011-03-09</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><subject><genre>Medicine & Public Health</genre><topic>Rheumatology</topic></subject><identifier type="ISSN">0770-3198</identifier><identifier type="eISSN">1434-9949</identifier><identifier type="JournalID">10067</identifier><identifier type="IssueArticleCount">26</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2011</date><detail type="volume"><number>30</number><caption>vol.</caption></detail><detail type="issue"><number>3</number><caption>no.</caption></detail><extent unit="pages"><start>303</start><end>312</end></extent></part><recordInfo><recordOrigin>Clinical Rheumatology, 2011</recordOrigin></recordInfo></relatedItem><identifier type="istex">6170A6E29924A786DFC34B4893BA016C5EE3A6E0</identifier><identifier type="ark">ark:/67375/VQC-R39TZ9DM-3</identifier><identifier type="DOI">10.1007/s10067-010-1596-y</identifier><identifier type="ArticleID">1596</identifier><identifier type="ArticleID">s10067-010-1596-y</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author(s), 2010</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>The Author(s), 2010</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-R39TZ9DM-3/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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