TY - JOUR
T1 - Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.
AU - Fonseca, João Eurico
AU - Canhão, Helena
AU - Reis, Paulo
AU - Santos, Maria José
AU - Branco, Jaime
AU - Quintal, Alberto
AU - Malcata, Armando
AU - Araújo, Domingos
AU - Ventura, Francisco
AU - Figueiredo, Guilherme
AU - da Silva, José Canas
AU - Patto, José Vaz
AU - Queiroz, Mário Viana
AU - Santos, Rui André
AU - Neto, Adriano José
AU - de Matos, J. Alves
AU - Rodrigues, Ana
AU - Mourão, Ana Filipa
AU - Ribeiro, Ana Sofia
AU - Cravo, Ana Rita
AU - Barcelos, Anabela
AU - Cardoso, Anabela
AU - Vilar, António
AU - Braña, Arecili
AU - Faustino, Augusto
AU - Silva, Candida
AU - Godinho, Fátima
AU - Cunha, Inês
AU - Costa, José António
AU - Gomes, José António Melo
AU - Pinto, José António Araújo
AU - da Silva, José António Pereira
AU - Miranda, Luís Cunha
AU - Inês, Luís Sousa
AU - Santos, Luís Maurício
AU - Cruz, Margarida
AU - Salvador, Maria João
AU - Ferreira, Maria Júlia
AU - Rial, Maria
AU - Bernardes, Miguel
AU - Bogas, Mónica
AU - Araújo, Paula
AU - Machado, Pedro
AU - Pinto, Patrícia
AU - de Melo, Rui Gomes
AU - Cortes, Sara
AU - Alcino, Sérgio
AU - Capela, Susana
PY - 2010/1
Y1 - 2010/1
N2 - The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).
AB - The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).
KW - Artrite Reumatóide
KW - Terapêutica Biológica
KW - Anti-TNF
KW - Rituximab
KW - Abatacept
KW - Tocilizumab
UR - http://www.scopus.com/inward/record.url?scp=77957598053&partnerID=8YFLogxK
M3 - Article
C2 - 20505635
AN - SCOPUS:77957598053
SN - 0303-464X
VL - 35
SP - 95
EP - 98
JO - Acta Reumatológica Portuguesa
JF - Acta Reumatológica Portuguesa
IS - 1
ER -