Biologic Disease-modifying Antirheumatic Drug Attributes in the First Lines of Treatment of Rheumatoid Arthritis. 2015 ACORDAR Project
Autor: | Santiago Muñoz-Fernández, Jaime Calvo Alén, José Manuel Rodríguez Heredia, José Javier Pérez Venegas, Hèctor Corominas, Nagore Fernández-Llanio Comella, Eugenio Chamizo Carmona, Susana Romero Yuste, María Sagrario Bustabad Reyes, Virginia Ruiz-Esquide Torino, Manuel Castaño Sanchez, María Cristina Hidalgo Calleja |
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Rok vydání: | 2018 |
Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty business.industry medicine.medical_treatment Clinical Decision-Making Delphi method General Medicine medicine.disease Biologic Disease-Modifying Antirheumatic Drug Arthritis Rheumatoid Biological Factors 03 medical and health sciences Treatment Outcome 0302 clinical medicine Interquartile range Antirheumatic Agents Rheumatoid arthritis Family medicine medicine Humans Biologic DMARD 030212 general & internal medicine Disease-modifying antirheumatic drug business Systematic search |
Zdroj: | Reumatología Clínica (English Edition). 14:90-96 |
ISSN: | 2173-5743 |
Popis: | 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. |
Databáze: | OpenAIRE |
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