Experts document on methotrexate use in combined therapy with biological or targeted synthetic disease modifying drugs in patients with rheumatoid arthritis Documento de expertos sobre el uso de terapia combinada de metotrexato con terapias biológicas o terapias dirigidas a pacientes con artritis reumatoide
Tornero-Molina, J. (Hospital de Guadalajara)
Alperi-López, M. (Hospital Universitario Central de Asturias)
Castellvi, Ivan (Institut d'Investigació Biomèdica Sant Pau)
De Agustin, Juan Jose (Hospital Universitari Vall d'Hebron)
Escudero, A. (Hospital Universitario Reina Sofía (Còrdova, Espanya))
García-Vicuña, R. (Hospital Universitario La Princesa)
González-Gay, M.Á. (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Hidalgo, C. (Complejo Asistencial Universitario de Salamanca)
Rubio, E. (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sanmartí, Raimon (Hospital Clínic i Provincial de Barcelona)
Casamira, N. (Laboratorios Gebro Pharma)
Calvo Alén, Jaime (Hospital Universitario Araba)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	We aimed to develop recommendations for the management of methotrexate (MTX) when considering the combination with biological (b) or targeted synthetic (ts) disease modifying drugs (DMARDs) in rheumatoid arthritis (RA). Eleven experts on RA were selected. Two coordinators formulated 13 questions about the combination therapy of MTX with bDMARDs or tsDMARDs. A systematic review was conducted to answer the questions. Inclusion and exclusion criteria were established as well as the search strategies (Medline, Embase and the Cochrane Library were searched up to January 2019). Two reviewers selected the articles and collected data. Simultaneously, EULAR and ACR meeting abstracts were evaluated. Based on this evidence, the coordinators proposed preliminary recommendations that the experts discussed and voted in a nominal group meeting. The level of evidence and grade of recommendation was established using the Oxford Center for Evidence Based Medicine and the level of agreement with a Delphi. Agreement was established if at least 80% of the experts voted 'yes' (yes/no). The systematic review retrieved 513 citations of which 61 were finally included. A total of 10 recommendations were generated, voted and accepted. The level of agreement was very high in all of them and it was achieved in the first Delphi round. Final recommendations cover aspects such as the optimal MTX dosage, tapering strategy or patients' risk management. This document is intended to help clinicians solve usual clinical questions and facilitate decision making when treating RA patients with MTX in combination with bDMARDs or tsDMARDs.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Castellà
Document:	Article ; recerca ; Versió publicada
Matèria:	Artritis reumatoide ; Combined therapy ; Disease modifying anti-rheumatic drugs ; Fármacos modificadores de la enfermedad ; Methotrexate ; Metotrexato ; Rheumatoid arthritis ; Terapia combinada
Publicat a:	Reumatologia Clinica, Vol. 18 Núm. 1 (enero 2022) , p. 33-41, ISSN 1885-1398

DOI: 10.1016/j.reuma.2020.08.003
PMID: 33041228

9 p, 964.3 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
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