RT Journal Article
SR Electronic
T1 Canadian Rheumatology Association Recommendations for the Pharmacological Management of Rheumatoid Arthritis with Traditional and Biologic Disease-modifying Antirheumatic Drugs: Part II Safety
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.120165
DO 10.3899/jrheum.120165
A1 Claire Bombardier
A1 Glen S. Hazlewood
A1 Pooneh Akhavan
A1 Orit Schieir
A1 Anne Dooley
A1 Boulos Haraoui
A1 Majed Khraishi
A1 Sharon A. LeClercq
A1 Jean Légaré
A1 Dianne P. Mosher
A1 James Pencharz
A1 Janet E. Pope
A1 John Thomson
A1 Carter Thorne
A1 Michel Zummer
A1 Michael A. Gardam
A1 Johan Askling
A1 Vivian Bykerk
YR 2012
UL http://www.jrheum.org/content/early/2012/06/11/jrheum.120165.abstract
AB Objective The Canadian Rheumatology Association (CRA) has developed recommendations for the pharmacological management of rheumatoid arthritis (RA) with traditional and biologic disease-modifying antirheumatic drugs (DMARD) in 2 parts. Part II, focusing on specific safety aspects of treatment with traditional and biologic DMARD in patients with RA, is reported here. Methods Key questions were identified a priori based on results of a national needs-assessment survey. A systematic review of all clinical practice guidelines and consensus statements regarding treatment with traditional and biologic DMARD in patients with RA published between January 2000 and June 2010 was performed in Medline, Embase, and CINAHL databases, and was supplemented with a “grey literature” search including relevant public health guidelines. Systematic reviews of postmarketing surveillance and RA registry studies were performed to update included guideline literature reviews as appropriate. Guideline quality was independently assessed by 2 reviewers. Guideline characteristics, recommendations, and supporting evidence from observational studies and randomized trials were synthesized into evidence tables. The working group voted on recommendations using a modified Delphi technique. Results Thirteen recommendations addressing perioperative care, screening for latent tuberculosis infection prior to the initiation of biologic DMARD, optimal vaccination practices, and treatment of RA patients with active or a history of malignancy were developed for rheumatologists, other primary prescribers of RA drug therapies, and RA patients. Conclusion These recommendations were developed based on a synthesis of international RA and public health guidelines, supporting evidence, and expert consensus in the context of the Canadian health system. They are intended to help promote best practices and improve healthcare delivery for persons with RA.