Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology
Identifieur interne : 001696 ( Main/Exploration ); précédent : 001695; suivant : 001697Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology
Auteurs : Chi Chiu Mok [Hong Kong] ; Lai Shan Tam [Hong Kong] ; Tak Hin Chan [Hong Kong] ; Gavin K. W. Lee [Hong Kong] ; Edmund K. M. Li [Hong Kong]Source :
- 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. 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.</div></front></TEI><affiliations><list><country><li>Hong Kong</li></country><region><li>Hong Kong</li></region><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><country name="Hong Kong"><noRegion><name sortKey="Mok, Chi Chiu" sort="Mok, Chi Chiu" uniqKey="Mok C" first="Chi Chiu" last="Mok">Chi Chiu Mok</name></noRegion><name sortKey="Chan, Tak Hin" sort="Chan, Tak Hin" uniqKey="Chan T" first="Tak Hin" last="Chan">Tak Hin Chan</name><name sortKey="Lee, Gavin K W" sort="Lee, Gavin K W" uniqKey="Lee G" first="Gavin K. W." last="Lee">Gavin K. W. Lee</name><name sortKey="Li, Edmund K M" sort="Li, Edmund K M" uniqKey="Li E" first="Edmund K. M." last="Li">Edmund K. M. Li</name><name sortKey="Tam, Lai Shan" sort="Tam, Lai Shan" uniqKey="Tam L" first="Lai Shan" last="Tam">Lai Shan Tam</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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