Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Chi Chiu Mok & Lai Shan Tam & Tak Hin Chan & Gavin K. W. Lee & Edmund K. M. Li & Hong Kong Society of Rheumatology
- چاپ و سال / کشور: 2011
Description
Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naive RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the antitumor necrosis factor (TNF)-ƒ؟ agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy
Clin Rheumatol (2011) 30:303–312 Received: 29 September 2010 / Accepted: 29 September 2010 / Published online: 3 November 2010
