Drug treatment algorithm and recommendations from the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis-secondary publication

被引：75

作者：

Kawahito, Yutaka ^{[1
]}

Morinobu, Akio ^{[2
]}

Kaneko, Yuko ^{[3
]}

Kohno, Masataka ^{[1
]}

Hirata, Shintaro ^{[4
]}

Kishimoto, Mitsumasa ^{[5
]}

Seto, Yohei ^{[6
]}

Sugihara, Takahiko ^{[7
]}

Tanaka, Eiichi ^{[8
]}

Ito, Hiromu ^{[9
,10
]}

Kojima, Toshihisa ^{[11
]}

Matsushita, Isao ^{[12
]}

Nishida, Keiichiro ^{[13
]}

Mori, Masaaki ^{[7
]}

Murashima, Atsuko ^{[14
]}

Yamanaka, Hisashi ^{[15
]}

Nakayama, Takeo ^{[16
]}

Kojima, Masayo ^{[17
]}

Harigai, Masayoshi ^{[8
]}

机构：

[1] Kyoto Prefectural Univ Med, Inflammat & Immunol, Kyoto, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Rheumatol & Clin Immunol, Kyoto, Japan

[3] Keio Univ, Dept Internal Med, Div Rheumatol, Sch Med, Tokyo, Japan

[4] Hiroshima Univ Hosp, Dept Clin Immunol & Rheumatol, Hiroshima, Japan

[5] Kyorin Univ, Dept Nephrol & Rheumatol, Sch Med, Tokyo, Japan

[6] Tokyo Womens Med Univ, Yachiyo Med Ctr, Dept Rheumatol, Yachiyo, Japan

[7] St Marianna Univ, Div Rheumatol & Allergol, Sch Med, Kawasaki, Kanagawa, Japan

[8] Tokyo Womens Med Univ, Dept Internal Med, Div Rheumatol, Sch Med, Tokyo, Japan

[9] Kyoto Univ, Dept Orthoped Surg, Grad Sch Med, Kyoto, Japan

[10] Kurashiki Cent Hosp, Dept Orthopaed Surg, Kurashiki, Okayama, Japan

[11] Nagoya Univ, Dept Orthoped Surg, Grad Sch Med, Nagoya, Aichi, Japan

[12] Kanazawa Med Univ, Dept Rehabil Med, Kanazawa, Ishikawa, Japan

[13] Okayama Univ, Dept Orthopaed Surg, Grad Sch Med Dens & Pharmaceut Sci, Okayama, Japan

[14] Natl Ctr Child Hlth & Dev, Ctr Maternal Fetal, Neonatal & Reprod Med Japan Drug Informat Inst Pr, Tokyo, Japan

[15] Sanno Med Ctr, Rheumatol, Tokyo, Japan

[16] Kyoto Univ, Dept Hlth Informat, Sch Publ Hlth, Kyoto, Japan

[17] Natl Ctr Geriatr & Gerontol, Ctr Gerontol & Social Sci, Dept Frailty Res, Obu, Japan

来源：

MODERN RHEUMATOLOGY | 2023年 / 33卷 / 01期

关键词：

Rheumatoid arthritis; drug treatment; guideline; recommendation; GRADE system; NECROSIS-FACTOR-ALPHA; INTERSTITIAL LUNG-DISEASE; BREAST-CANCER RECURRENCE; ANTI-TNF THERAPY; DOUBLE-BLIND; BIOLOGIC AGENTS; CARDIOVASCULAR EVENTS; VACCINE RESPONSES; STRUCTURAL DAMAGE; FACTOR INHIBITORS;

D O I：

10.1093/mr/roac017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective The aim of this study was to update the Japan College of Rheumatology (JCR) clinical practice guidelines (CPG) for the management of rheumatoid arthritis (RA; JCR CPG for RA) according to recent changes in the medical environment in Japan. This article is a digest version of the guidance. Methods We used the Grading of Recommendations, Assessment, Development, and Evaluation method to update the 2014 JCR CPG for RA. A consensus was formed by CPG panel members. Results We identified 36 important clinical questions regarding drug treatment and developed corresponding recommendations for RA. The recommendations included the following RA medications: non-steroidal anti-inflammatory drugs, corticosteroids, conventional synthetic disease-modifying antirheumatic drugs, biological disease-modifying antirheumatic drugs, anti-receptor activator for nuclear factor-kappa B ligand antibodies, and Janus kinase inhibitors, as well as the tapering and discontinuation of these medications. Recommendations regarding the efficacy and safety of treatments in the elderly and patients with comorbidities were also developed. Finally, we used these recommendations to create an original algorithm for drug treatment for RA based on the Treat-to-Target approach. Conclusion The 2020 JCR CPG for RA provides a useful tool for rheumatologists, health care professionals, and patients with RA, enabling shared decision-making in a variety of clinical situations.

引用

页码：21 / 35

页数：15

共 56 条

[1]

2014 Japan College of Rheumatology, 2014, GUIDELINES MANAGEMEN

[2] Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies [J].