Update of 2008 guidelines addresses screening for TB, immunization, treatment in high-risk patients
THURSDAY, April 5 (HealthDay News) -- The 2008 American College of Rheumatology (ACR) guidelines for the treatment of rheumatoid arthritis (RA) have been updated for 2012, according to a special article published in the May issue of Arthritis Care & Research.
Jasvinder A. Singh, M.B.B.S., M.P.H., from the University of Alabama at Birmingham, and colleagues conducted a systematic literature review to update the 2008 ACR guidelines for the use of disease-modifying antirheumatic drugs (DMARDs) and biologic agents in the treatment of RA.
The panel of authors recommend targeting low disease activity or remission in all patients with early RA and patients with established RA receiving any DMARD or biologic agent. In patients with early RA, DMARD monotherapy is recommended for low and moderate/high disease activity in the absence of poor prognostic features, and combination therapy is advised for patients with moderate/high disease activity and poor prognostic features. After three months of DMARD therapy for established RA, patients with moderate or high disease activity could add or switch among DMARDs or switch from DMARDs to biologic agents. The panel also offers recommendations for treating RA patients who have additional complications, including hepatitis, cancer, and chronic heart failure.
"These recommendations, which focus on common clinical scenarios, should be used as a guide for clinicians treating RA patients, with the clear understanding that the best treatment decision can only be made by the clinician in discussions with patients," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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