Arthritis Care & Research· 2021Q1· Guideline
2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
- 1,301citations
- Q1SCImago
- 2021year
Short summary
Updated 2021 ACR guidelines offer 44 recommendations for rheumatoid arthritis pharmacologic management, including DMARDs (conventional synthetic, biologic, targeted synthetic), glucocorticoids, and specific high-risk populations.
AI-generated from the title and abstract; the full text is not read.
Key points
- The guideline offers 44 recommendations for rheumatoid arthritis pharmacologic treatment.
- Recommendations cover conventional synthetic, biologic, and targeted synthetic DMARDs, as well as glucocorticoids.
- Specific guidance is provided for high-risk populations with liver disease, heart failure, or previous serious infections.
- The guideline emphasizes shared decision-making between clinicians and patients, considering individual values and comorbidities.
AI-generated from the title and abstract; the full text is not read.
Abstract
OBJECTIVE: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis. METHODS: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence. A voting panel comprising clinicians and patients achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS: The guideline addresses treatment with disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs, biologic DMARDs, and targeted synthetic DMARDs, use of glucocorticoids, and use of DMARDs in certain high-risk populations (i.e., those with liver disease, heart failure, lymphoproliferative disorders, previous serious infections, and nontuberculous mycobacterial lung disease). The guideline includes 44 recommendations (7 strong and 37 conditional). CONCLUSION: This clinical practice guideline is intended to serve as a tool to support clinician and patient decision-making. Recommendations are not prescriptive, and individual treatment decisions should be made through a shared decision-making process based on patients' values, goals, preferences, and comorbidities.
The authors' abstract, as published at the source. Arthritis Care & Research, 2021 · DOI ↗
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Field: Rheumatology
RheumatologyMedicine