Treating rheumatoid arthritis to target: recommendations of an international task force
Identifieur interne : 003C85 ( Main/Exploration ); précédent : 003C84; suivant : 003C86Treating rheumatoid arthritis to target: recommendations of an international task force
Auteurs : Josef S. Smolen [Autriche] ; Daniel Aletaha [Autriche] ; Johannes W J. Bijlsma [Pays-Bas] ; Ferdinand C. Breedveld [Pays-Bas] ; Dimitrios Boumpas [Grèce] ; Gerd Burmester [Allemagne] ; Bernard Combe [France] ; Maurizio Cutolo [Italie] ; Maarten De Wit [Suisse] ; Maxime Dougados [France] ; Paul Emery [Royaume-Uni] ; Alan Gibofsky [États-Unis] ; Juan Jesus Gomez-Reino [Espagne] ; Boulos Haraoui [Canada] ; Joachim Kalden [Allemagne] ; Edward C. Keystone [Canada] ; Tore K. Kvien [Norvège] ; Iain Mcinnes [Royaume-Uni] ; Emilio Martin-Mola [Espagne] ; Carlomaurizio Montecucco [Italie] ; Monika Schoels [Autriche] ; Desirée Van Der Heijde [Pays-Bas]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2010-04.
English descriptors
- Teeft :
- Acceptable alternative, Active disease, Acute phase reactants, Aletaha, Alternative goal, Alternative target, American college, Anonymous fashion, Arthritis, Arthritis rheum, Available evidence, Biological agents, Bullet point, Clear target, Clinical decisions, Clinical immunology, Clinical practice, Clinical remission, Clinical trial, Clinical trials, Collaborative recommendations, Composite disease activity measures, Composite indices, Composite measure, Composite measures, Control examinations, Disease activity, Disease activity score, Disease activity states, Drug therapy, Erythrocyte sedimentation rate, Eular, Expert committee, Expert opinion, Functional capacity, Functional impairment, Functional status, Guide treatment decisions, Heijde, High disease activity, Individual items, Individual patients, Internal medicine, Joint assessments, Joint counts, Joint damage, Literature review, Many patients, Maximise quality, Medical university, Methotrexate, Methotrexate monotherapy, Optimises outcomes, Other hand, Outcome measures, Patient factors, Physical disability, Primary goal, Primary target, Progression, Prospective study, Radiographic damage, Radiologic damage, Remission, Rheum, Rheumatic diseases, Rheumatoid, Rheumatoid arthritis, Rheumatoid arthritis patients, Rheumatol, Rheumatologist, Rheumatology, Shorter term, Smolen, Social participation, Steering committee, Structural changes, Structural damage, Systematic literature, Systematic literature review, Target value, Task force, Therapeutic options, Therapeutic target, Treatment strategies, Treatment target, Treatment targets.
Abstract
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.
Url:
- https://api.istex.fr/ark:/67375/NVC-HBN2NF7X-V/fulltext.pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015099
DOI: 10.1136/ard.2009.123919
Affiliations:
- Allemagne, Autriche, Canada, Espagne, France, Grèce, Italie, Norvège, Pays-Bas, Royaume-Uni, Suisse, États-Unis
- Angleterre, Bavière, Berlin, Communauté de Madrid, District de Moyenne-Franconie, Hollande-Méridionale, Languedoc-Roussillon, Occitanie (région administrative), Ontario, Utrecht (province), Vienne (Autriche), Yorkshire-et-Humber, Écosse, État de New York, Île-de-France, Østlandet
- Berlin, Erlangen, Glasgow, Leeds, Leyde, Madrid, Montpellier, Oslo, Paris, Toronto, Utrecht, Vienne (Autriche)
- Université de Glasgow, Université de Leeds, Université de Toronto
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Bijlsma</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>University Medical Center Utrecht, Department of Rheumatology and Clinical Immunology, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Breedveld, Ferdinand C" sort="Breedveld, Ferdinand C" uniqKey="Breedveld F" first="Ferdinand C" last="Breedveld">Ferdinand C. 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Clinical Immunology, Charite Hospital, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Service d'Immuno-Rhumatologie, Montpellier University, Lapeyronie Hospital, Montpellier</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Cutolo, Maurizio" sort="Cutolo, Maurizio" uniqKey="Cutolo M" first="Maurizio" last="Cutolo">Maurizio Cutolo</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Research Laboratory and Academic Clinical Unit of Rheumatology, Department of Internal Medicine, University of Genova, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="De Wit, Maarten" sort="De Wit, Maarten" uniqKey="De Wit M" first="Maarten" last="De Wit">Maarten De Wit</name><affiliation wicri:level="1"><country xml:lang="fr">Suisse</country><wicri:regionArea>EULAR Standing Committee of People with Arthritis/Rheumatism in Europe, Zurich</wicri:regionArea><wicri:noRegion>Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>René Descartes University, Cochin Hospital, Department of Rheumatology B, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Gibofsky, Alan" sort="Gibofsky, Alan" uniqKey="Gibofsky A" first="Alan" last="Gibofsky">Alan Gibofsky</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Weill Medical College, Cornell University Hospital for Special Surgery, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Gomez Reino, Juan Jesus" sort="Gomez Reino, Juan Jesus" uniqKey="Gomez Reino J" first="Juan Jesus" last="Gomez-Reino">Juan Jesus Gomez-Reino</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Santiago University Clinical Hospital, NEIRID Laboratory, Santiago de Compostela</wicri:regionArea><wicri:noRegion>Santiago de Compostela</wicri:noRegion></affiliation></author><author><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Institut de rhumatologie de Montréal, Montréal, QC</wicri:regionArea><wicri:noRegion>QC</wicri:noRegion></affiliation></author><author><name sortKey="Kalden, Joachim" sort="Kalden, Joachim" uniqKey="Kalden J" first="Joachim" last="Kalden">Joachim Kalden</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Fiebiger Center, Friedrich-Alexander University, Erlangen</wicri:regionArea><placeName><settlement type="city">Erlangen</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Moyenne-Franconie</region></placeName></affiliation></author><author><name sortKey="Keystone, Edward C" sort="Keystone, Edward C" uniqKey="Keystone E" first="Edward C" last="Keystone">Edward C. Keystone</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Kvien, Tore K" sort="Kvien, Tore K" uniqKey="Kvien T" first="Tore K" last="Kvien">Tore K. Kvien</name><affiliation wicri:level="3"><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Rheumatology, Diakonhjemmet Hospital, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Mcinnes, Iain" sort="Mcinnes, Iain" uniqKey="Mcinnes I" first="Iain" last="Mcinnes">Iain Mcinnes</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Glasgow, Glasgow</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="Martin Mola, Emilio" sort="Martin Mola, Emilio" uniqKey="Martin Mola E" first="Emilio" last="Martin-Mola">Emilio Martin-Mola</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>La Paz Hospital, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, University of Pavia, IRCCS Policlinico S Matteo, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Schoels, Monika" sort="Schoels, Monika" uniqKey="Schoels M" first="Monika" last="Schoels">Monika Schoels</name><affiliation wicri:level="3"><country xml:lang="fr">Autriche</country><wicri:regionArea>2nd Department of Medicine, Center for Rheumatic Diseases, Hietzing Hospital, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Desirée" last="Van Der Heijde">Desirée Van Der Heijde</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Leiden University Medical Center, Department of Rheumatology, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2010-04">2010-04</date><biblScope unit="volume">69</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="631">631</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acceptable alternative</term><term>Active disease</term><term>Acute phase reactants</term><term>Aletaha</term><term>Alternative goal</term><term>Alternative target</term><term>American college</term><term>Anonymous fashion</term><term>Arthritis</term><term>Arthritis rheum</term><term>Available evidence</term><term>Biological agents</term><term>Bullet point</term><term>Clear target</term><term>Clinical decisions</term><term>Clinical immunology</term><term>Clinical practice</term><term>Clinical remission</term><term>Clinical trial</term><term>Clinical trials</term><term>Collaborative recommendations</term><term>Composite disease activity measures</term><term>Composite indices</term><term>Composite measure</term><term>Composite measures</term><term>Control examinations</term><term>Disease activity</term><term>Disease activity score</term><term>Disease activity states</term><term>Drug therapy</term><term>Erythrocyte sedimentation rate</term><term>Eular</term><term>Expert committee</term><term>Expert opinion</term><term>Functional capacity</term><term>Functional impairment</term><term>Functional status</term><term>Guide treatment decisions</term><term>Heijde</term><term>High disease activity</term><term>Individual items</term><term>Individual patients</term><term>Internal medicine</term><term>Joint assessments</term><term>Joint counts</term><term>Joint damage</term><term>Literature review</term><term>Many patients</term><term>Maximise quality</term><term>Medical university</term><term>Methotrexate</term><term>Methotrexate monotherapy</term><term>Optimises outcomes</term><term>Other hand</term><term>Outcome measures</term><term>Patient factors</term><term>Physical disability</term><term>Primary goal</term><term>Primary target</term><term>Progression</term><term>Prospective study</term><term>Radiographic damage</term><term>Radiologic damage</term><term>Remission</term><term>Rheum</term><term>Rheumatic diseases</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatoid arthritis patients</term><term>Rheumatol</term><term>Rheumatologist</term><term>Rheumatology</term><term>Shorter term</term><term>Smolen</term><term>Social participation</term><term>Steering committee</term><term>Structural changes</term><term>Structural damage</term><term>Systematic literature</term><term>Systematic literature review</term><term>Target value</term><term>Task force</term><term>Therapeutic options</term><term>Therapeutic target</term><term>Treatment strategies</term><term>Treatment target</term><term>Treatment targets</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">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.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Autriche</li><li>Canada</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Norvège</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bavière</li><li>Berlin</li><li>Communauté de Madrid</li><li>District de Moyenne-Franconie</li><li>Hollande-Méridionale</li><li>Languedoc-Roussillon</li><li>Occitanie (région administrative)</li><li>Ontario</li><li>Utrecht (province)</li><li>Vienne (Autriche)</li><li>Yorkshire-et-Humber</li><li>Écosse</li><li>État de New York</li><li>Île-de-France</li><li>Østlandet</li></region><settlement><li>Berlin</li><li>Erlangen</li><li>Glasgow</li><li>Leeds</li><li>Leyde</li><li>Madrid</li><li>Montpellier</li><li>Oslo</li><li>Paris</li><li>Toronto</li><li>Utrecht</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université de Glasgow</li><li>Université de Leeds</li><li>Université de Toronto</li></orgName></list><tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name></region><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name><name sortKey="Schoels, Monika" sort="Schoels, Monika" uniqKey="Schoels M" first="Monika" last="Schoels">Monika Schoels</name><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Bijlsma, Johannes W J" sort="Bijlsma, Johannes W J" uniqKey="Bijlsma J" first="Johannes W J" last="Bijlsma">Johannes W J. Bijlsma</name></region><name sortKey="Breedveld, Ferdinand C" sort="Breedveld, Ferdinand C" uniqKey="Breedveld F" first="Ferdinand C" last="Breedveld">Ferdinand C. Breedveld</name><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Desirée" last="Van Der Heijde">Desirée Van Der Heijde</name></country><country name="Grèce"><noRegion><name sortKey="Boumpas, Dimitrios" sort="Boumpas, Dimitrios" uniqKey="Boumpas D" first="Dimitrios" last="Boumpas">Dimitrios Boumpas</name></noRegion></country><country name="Allemagne"><region name="Berlin"><name sortKey="Burmester, Gerd" sort="Burmester, Gerd" uniqKey="Burmester G" first="Gerd" last="Burmester">Gerd Burmester</name></region><name sortKey="Kalden, Joachim" sort="Kalden, Joachim" uniqKey="Kalden J" first="Joachim" last="Kalden">Joachim Kalden</name></country><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name></region><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name></country><country name="Italie"><noRegion><name sortKey="Cutolo, Maurizio" sort="Cutolo, Maurizio" uniqKey="Cutolo M" first="Maurizio" last="Cutolo">Maurizio Cutolo</name></noRegion><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name></country><country name="Suisse"><noRegion><name sortKey="De Wit, Maarten" sort="De Wit, Maarten" uniqKey="De Wit M" first="Maarten" last="De Wit">Maarten De Wit</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name></region><name sortKey="Mcinnes, Iain" sort="Mcinnes, Iain" uniqKey="Mcinnes I" first="Iain" last="Mcinnes">Iain Mcinnes</name></country><country name="États-Unis"><region name="État de New York"><name sortKey="Gibofsky, Alan" sort="Gibofsky, Alan" uniqKey="Gibofsky A" first="Alan" last="Gibofsky">Alan Gibofsky</name></region></country><country name="Espagne"><noRegion><name sortKey="Gomez Reino, Juan Jesus" sort="Gomez Reino, Juan Jesus" uniqKey="Gomez Reino J" first="Juan Jesus" last="Gomez-Reino">Juan Jesus Gomez-Reino</name></noRegion><name sortKey="Martin Mola, Emilio" sort="Martin Mola, Emilio" uniqKey="Martin Mola E" first="Emilio" last="Martin-Mola">Emilio Martin-Mola</name></country><country name="Canada"><noRegion><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name></noRegion><name sortKey="Keystone, Edward C" sort="Keystone, Edward C" uniqKey="Keystone E" first="Edward C" last="Keystone">Edward C. Keystone</name></country><country name="Norvège"><region name="Østlandet"><name sortKey="Kvien, Tore K" sort="Kvien, Tore K" uniqKey="Kvien T" first="Tore K" last="Kvien">Tore K. Kvien</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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