Actualización del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas y sintéticas dirigidas en la artritis reumatoide

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-01 DOI:10.1016/j.reuma.2024.05.007

José María Álvaro-Gracia Álvaro , Petra Díaz del Campo Fontecha , José Luis Andréu Sánchez , Alejandro Balsa Criado , Rafael Cáliz Cáliz , Isabel Castrejón Fernández , Hèctor Corominas , José A. Gómez Puerta , Sara Manrique Arija , Natalia Mena Vázquez , Ana Ortiz García , Chamaida Plasencia Rodríguez , Lucía Silva Fernández , Jesús Tornero Molina

{"title":"Actualización del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas y sintéticas dirigidas en la artritis reumatoide","authors":"José María Álvaro-Gracia Álvaro , Petra Díaz del Campo Fontecha , José Luis Andréu Sánchez , Alejandro Balsa Criado , Rafael Cáliz Cáliz , Isabel Castrejón Fernández , Hèctor Corominas , José A. Gómez Puerta , Sara Manrique Arija , Natalia Mena Vázquez , Ana Ortiz García , Chamaida Plasencia Rodríguez , Lucía Silva Fernández , Jesús Tornero Molina","doi":"10.1016/j.reuma.2024.05.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To update the consensus document of the Spanish Society of Rheumatology (SER) regarding the use of targeted biological and synthetic therapies in rheumatoid arthritis (RA) with the aim of assisting clinicians in their therapeutic decisions.</div></div><div><h3>Methods</h3><div>A panel of 13 experts was assembled through an open call by SER. We employed a mixed adaptation-elaboration-update methodology starting from the 2015 Consensus Document of the Spanish Society of Rheumatology on the use of biological therapies in RA. Starting with systematic reviews (SR) of recommendations from EULAR 2019, American College of Rheumatology 2021, and GUIPCAR 2017, we updated the search strategies for the PICO questions of GUIPCAR. An additional SR was conducted on demyelinating disease in relation to targeted biological and synthetic therapies. Following the analysis of evidence by different panelists, consensus on the wording and level of agreement for each recommendation was reached in a face-to-face meeting.</div></div><div><h3>Results</h3><div>The panel established 5 general principles and 15 recommendations on the management of RA. These encompassed crucial aspects such as the importance of early treatment, therapeutic goals in RA, monitoring frequency, the use of glucocorticoids, the application of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs. Additionally, recommendations on dose reduction of these drugs in stable patients were included. This update also features recommendations on the use of bDMARDs and Janus Kinase inhibitors in some specific clinical situations, such as patients with lung disease, a history of cancer, heart failure, or demyelinating disease.</div></div><div><h3>Conclusions</h3><div>This update provides recommendations on key aspects in the management of RA using targeted biological and synthetic therapies.</div></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1699258X24000676","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To update the consensus document of the Spanish Society of Rheumatology (SER) regarding the use of targeted biological and synthetic therapies in rheumatoid arthritis (RA) with the aim of assisting clinicians in their therapeutic decisions.

Methods

A panel of 13 experts was assembled through an open call by SER. We employed a mixed adaptation-elaboration-update methodology starting from the 2015 Consensus Document of the Spanish Society of Rheumatology on the use of biological therapies in RA. Starting with systematic reviews (SR) of recommendations from EULAR 2019, American College of Rheumatology 2021, and GUIPCAR 2017, we updated the search strategies for the PICO questions of GUIPCAR. An additional SR was conducted on demyelinating disease in relation to targeted biological and synthetic therapies. Following the analysis of evidence by different panelists, consensus on the wording and level of agreement for each recommendation was reached in a face-to-face meeting.

Results

The panel established 5 general principles and 15 recommendations on the management of RA. These encompassed crucial aspects such as the importance of early treatment, therapeutic goals in RA, monitoring frequency, the use of glucocorticoids, the application of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs. Additionally, recommendations on dose reduction of these drugs in stable patients were included. This update also features recommendations on the use of bDMARDs and Janus Kinase inhibitors in some specific clinical situations, such as patients with lung disease, a history of cancer, heart failure, or demyelinating disease.

Conclusions

This update provides recommendations on key aspects in the management of RA using targeted biological and synthetic therapies.

查看原文本刊更多论文

西班牙风湿病学会关于在类风湿性关节炎中使用生物和合成靶向疗法的共识文件更新版

目的更新西班牙风湿病学会（SER）关于类风湿性关节炎（RA）使用靶向生物和合成疗法的共识文件，以协助临床医生做出治疗决策。方法通过西班牙风湿病学会的公开征集，组建了一个由 13 位专家组成的小组。我们从 2015 年西班牙风湿病学会关于在 RA 中使用生物疗法的共识文件开始，采用了改编-阐述-更新的混合方法。从 EULAR 2019、American College of Rheumatology 2021 和 GUIPCAR 2017 建议的系统回顾（SR）开始，我们更新了 GUIPCAR PICO 问题的检索策略。我们还就脱髓鞘疾病与靶向生物和合成疗法的关系进行了额外的SR研究。不同的专家组成员对证据进行分析后，在一次面对面的会议上就每项建议的措辞和一致程度达成了共识。这些建议包括早期治疗的重要性、RA 的治疗目标、监测频率、糖皮质激素的使用、常规合成改善病情抗风湿药（csDMARDs）、生物 DMARDs（bDMARDs）和靶向合成 DMARDs 的应用等重要方面。此外，还包括对病情稳定的患者减少这些药物剂量的建议。本更新版还就在某些特殊临床情况下使用生物DMARDs和Janus激酶抑制剂提出了建议，如患有肺部疾病、癌症病史、心力衰竭或脱髓鞘疾病的患者。结论本更新版就使用靶向生物和合成疗法治疗RA的关键方面提出了建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.