Biologic Disease-modifying antirheumatic drug attributes in the first lines of treatment of rheumatoid arthritis. 2015 ACORDAR project.

Autor: Muñoz-Fernández S; Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, San Sebastián de los Reyes, Madrid, España. Electronic address: santiago.munoz@salud.madrid.org., Bustabad Reyes MS; Hospital Universitario de Canarias, Santa Cruz de Tenerife, España., Calvo Alén J; Hospital Universitario Araba, Vitoria, Álava, España., Castaño Sánchez M; Hospital Universitario Virgen de la Arrixaca, Murcia, España., Chamizo Carmona E; Hospital de Mérida , Mérida, Badajoz, España., Corominas H; Hospital Moisés Broggi, Sant Joan Despí, Barcelona, España., Fernández-Llanio Comella N; Hospital Arnau de Vilanova, Valencia, España., Hidalgo Calleja MC; Hospital Clínico de Salamanca, Salamanca, España., Pérez Venegas JJ; Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España., Rodríguez Heredia JM; Hospital Universitario de Getafe, Getafe, Madrid, España., Romero Yuste SM; Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España., Ruiz-Esquide Torino V; Hospital Clínic i Provincial, Barcelona, España.
Jazyk: English; Spanish; Castilian
Zdroj: Reumatologia clinica [Reumatol Clin (Engl Ed)] 2018 Mar - Apr; Vol. 14 (2), pp. 90-96. Date of Electronic Publication: 2017 Jan 03.
DOI: 10.1016/j.reuma.2016.10.001
Abstrakt: Objective: To date, between 17% and 35% of patients with rheumatoid arthritis (RA) do not respond as expected to the initial biological therapy. The objective of this project is to recognize and weigh the attributes of biologic DMARD (bDMARD) to identify the most appropriate for each case, in the first lines of treatment of RA (after inadequate response to at least one synthetic DMARD or previous bDMARD).
Methods: To recognize the possible attributes that could define the bDMARD, we performed a systematic search of the literature that recognized the possible attributes involving general aspects, pharmacology, efficacy, safety, management, and cost. Then a Delphi process was conducted with two rounds among a group of selected expert rheumatologists in the management of RA indicating the degree of agreement with the attributes identified in the literature. The project was completed between February and September 2015, indicating the degree of importance that was ascribed to each attribute. Two criteria were applied to determine the consistency of results: 1) based on the median and interquartile range; and 2) on the simultaneous compliance with mean, median, standard deviation, interquartile range and coefficient of variation. The agreement and final ratification of the expert panel were also determined.
Results: Eighty-three Spanish rheumatologists participated and completed both rounds of the Delphi process. In no case was the importance of the 77 attributes identified considered to be low; 75 of 77 (97.4%) were considered highly important and 76 of 77 (98.7%) were ratified. Fifteen attributes had the support of 100% of the working group.
Conclusions: There was a high degree of agreement concerning the selected attributes. Fifteen of them had the support of 100% of the working group and could be considered the definition of the ideal bDMARD in the first lines of RA treatment.
(Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.)
Databáze: MEDLINE
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