Canadian Rheumatology Association living guidelines for the pharmacological management of rheumatoid arthritis with disease-modifying anti-rheumatic drugs

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Arthritis Research Canada, Vancouver, BC, Canada; Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Special Surgery, New York, New York; Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada; Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan; The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, ON; Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario. Funding: Funding for this guideline was provided by the Canadian Rheumatology Association. Conflicts of interest: G Hazlewood: None; J Pardo: Funding from Canadian Rheumatology Association to Cochrane Musculoskeletal to provide methodological support for guideline development. C Barnabe: Honoraria for advisory boards (Gilead, Sanofi, Celltrion) and speaker fees (Sanofi) in past 3 years; O Schieir: None; C Barber: None; L Proulx: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. LP has received payment and travel support in the last 3 years from Lilly Canada (sharing patient perspectives at an event); D. Richards: Volunteer Vice President of Canadian Arthritis Patient Alliance which receives the majority of its funding from independent grants from pharmaceutical companies. DR's employer, Five02 Labs Inc, has received payment in the last 3 years from Novo Nordisk Canada (speaking on living with arthritis and arthritis advocacy) and Lilly Canada (sharing patient story, participating in an advisory board); P Tugwell: None; N Bansback: None; P Akhavan: Honoraria for advisory boards (Janssen, Eli Lilly, Pfizer, Sandoz, Celltrion, AbbVie, Roche); C Bombardier: Consulting for Novartis, Samsung. Honoraria for AbbVie, Janssen, Merck, Pfizer, GSK, Mylan; V Bykerk: Consultant: Amgen, BMS, Gilead, Genzyme, Regeneron, UCB; Research funding: Amgen, BMS, Genzyme, Pfizer, Sanofi Aventis, UCB; S Jamal: Honoraria for advisory boards (Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Eli Lilly, Fresenius Kabi, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, Teva, UCB); M Khraishi: Consulting for Amgen, Abbvie, Celgene, Merck, Novartis, Pfizer, Gilead; R Taylor-Gjevre: None; C Thorne: Consulting for Celgene, AbbVie, Merck, Pfizer, Sandoz; A Agarwal: None; JE Pope: Consulting for AbbVie, Amgen, BI, BMS, Celltrion, Fresenius Kabi, Galapagos, Gilead, Janssen, Lilly, Medexus, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Roche, Sandoz, Samsung, Sanofi, Sobi, Teva, UCB, VIatris. Correspondence to: Glen S Hazlewood, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada. E-mail: gshazlew@ucalgary.ca