Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.

João Eurico Fonseca, Helena Canhão, Paulo Reis, Maria José Santos, Jaime Branco, Alberto Quintal, Armando Malcata, Domingos Araújo, Francisco Ventura, Guilherme Figueiredo, José Canas da Silva, José Vaz Patto, Mário Viana Queiroz, Rui André Santos, Adriano José Neto, J. Alves de Matos, Ana Rodrigues, Ana Filipa Mourão, Ana Sofia Ribeiro, Ana Rita CravoAnabela Barcelos, Anabela Cardoso, António Vilar, Arecili Braña, Augusto Faustino, Candida Silva, Fátima Godinho, Inês Cunha, José António Costa, José António Melo Gomes, José António Araújo Pinto, José António Pereira da Silva, Luís Cunha Miranda, Luís Sousa Inês, Luís Maurício Santos, Margarida Cruz, Maria João Salvador, Maria Júlia Ferreira, Maria Rial, Miguel Bernardes, Mónica Bogas, Paula Araújo, Pedro Machado, Patrícia Pinto, Rui Gomes de Melo, Sara Cortes, Sérgio Alcino, Susana Capela

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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).

Original languageEnglish
Pages (from-to)95-98
Number of pages4
JournalActa Reumatológica Portuguesa
Issue number1
Publication statusPublished - Jan 2010


  • Artrite Reumatóide
  • Terapêutica Biológica
  • Anti-TNF
  • Rituximab
  • Abatacept
  • Tocilizumab


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