2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis - PubMed (original) (raw)

Practice Guideline

. 2021 Jul;73(7):1108-1123.

doi: 10.1002/art.41752. Epub 2021 Jun 8.

Joan M Bathon 2, Bryant R England 3, E William St Clair 4, Thurayya Arayssi 5, Kristine Carandang 6, Kevin D Deane 7, Mark Genovese 8, Kent Kwas Huston 9, Gail Kerr 10, Joel Kremer 11, Mary C Nakamura 12, Linda A Russell 13, Jasvinder A Singh 14, Benjamin J Smith 15, Jeffrey A Sparks 16, Shilpa Venkatachalam 17, Michael E Weinblatt 16, Mounir Al-Gibbawi 18, Joshua F Baker 19, Kamil E Barbour 20, Jennifer L Barton 21, Laura Cappelli 22, Fatimah Chamseddine 18, Michael George 23, Sindhu R Johnson 24, Lara Kahale 18, Basil S Karam 18, Assem M Khamis 18, Iris Navarro-Millán 25, Reza Mirza 26, Pascale Schwab 21, Namrata Singh 27, Marat Turgunbaev 28, Amy S Turner 28, Sally Yaacoub 18, Elie A Akl 18

Affiliations

Practice Guideline

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis

Liana Fraenkel et al. Arthritis Rheumatol. 2021 Jul.

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.

© 2021, American College of Rheumatology.

PubMed Disclaimer

Comment in

Similar articles

Cited by

References

    1. Singh JA, Saag KG, Bridges SL Jr, Akl EA, Bannuru RR, Sullivan MC, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016;68:1-26.
    1. Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum 2008;59:762-84.
    1. Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012;64:625-39.
    1. Goodman SM, Springer B, Guyatt G, Abdel MP, Dasa V, George M, et al. 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty. Arthritis Rheumatol 2017;69:1538-51.
    1. Sammaritano LR, Bermas BL, Chakravarty EE, Chambers C, Clowse ME, Lockshin MD, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Care Res (Hoboken) 2020;72:461-88.

Publication types

MeSH terms

Substances

LinkOut - more resources