German 2012 guidelines for the sequential medical treatment of rheumatoid arthritis. Adapted EULAR recommendations and updated treatment algorithm

被引：0

作者：

Krueger, K. ^{[1
]}

Wollenhaupt, J. ^{[2
]}

Albrecht, K. ^{[3
]}

Alten, R. ^{[4
]}

Backhaus, M. ^{[5
]}

Baerwald, C. ^{[6
]}

Bolten, W. ^{[7
]}

Braun, J. ^{[8
]}

Burkhardt, H. ^{[9
]}

Burmester, G.

Gaubitz, M. ^{[10
]}

Gause, A.

Gromnica-Ihle, E. ^{[11
]}

Kellner, H. ^{[12
]}

Kuipers, J. ^{[13
]}

Krause, A. ^{[14
]}

Lorenz, H. -M. ^{[15
,16
]}

Manger, B. ^{[17
]}

Nuesslein, H.

Pott, H. -G.

Rubbert-Roth, A. ^{[18
]}

Schneider, M. ^{[19
]}

Specker, C. ^{[20
]}

Schulze-Koops, H. ^{[21
]}

Tony, H. -P. ^{[22
]}

Wassenberg, S. ^{[23
]}

Mueller-Ladner, U. ^{[24
]}

机构：

[1] Praxiszentrum Rheumatol, D-81541 Munich, Germany

[2] Schon Klin Hamburg Eilbek, Klin Rheumatol & Klin Immunol, Hamburg, Germany

[3] Deutsch Gesell Rheumatol, Berlin, Germany

[4] Schlosspk Klin, Klin Immunol & Osteol, Berlin, Germany

[5] Charite Univ Med Berlin, Med Klin Schwerpunkt Rheumatol & Klin Immunol, Berlin, Germany

[6] Univ Klinikum Leipzig, Dept Innere Med Neurol & Dermatol, Sekt Rheumatol Gerontol, Leipzig, Germany

[7] Klaus Miehlke Klin, Abt Innere Med & Rheumatol, Wiesbaden, Germany

[8] St Josefs Hosp, Rheumazentrum Ruhrgebiet, Herne, Germany

[9] Klinikum Johann Wolfgang Goethe Univ, Med Klin 2, Abt Rheumatol, Frankfurt, Germany

[10] WWU Munster, Munster, Germany

[11] Deutsch Rheuma Liga, Bundesverband, Germany

[12] Krankenhaus Neuwittelsbach, Abt Rheumatol, Munich, Germany

[13] Rotes Kreuz Krankenhaus Bremen, Klin Internist Rheumatol, Bremen, Germany

[14] Immanuel Krankenhaus Berlin, Rheumaklin Berlin Buch, Berlin, Germany

[15] Univ Klinikum Heidelberg, Med Klin 5, Heidelberg, Germany

[16] ACURA Rheumazentrum, Baden Baden, Germany

[17] Univ Klinikum Erlangen, Med Klin 3, Erlangen, Germany

[18] Univ Klinikum Koln, Klin Innere Med Klin Immunol & Rheumatol 1, Cologne, Germany

[19] Univ Dusseldorf, D-40225 Dusseldorf, Germany

[20] Kliniken Essen S, Abt Rheumatol & Klin Immunol, Essen, Germany

[21] Klinikum LMU Munchen, Med Klin 4, Munich, Germany

[22] Klinikum Univ Wurzburg, Med Klin Rheumatol Klin Immunol 2, Wurzburg, Germany

[23] Evangel Fachkrankenhaus Ratingen, Ratingen, Germany

[24] Univ Giessen, Abt Rheumatol & Klin Immunol, Kerckhoff Klin, Bad Nauheim, Germany

来源：

ZEITSCHRIFT FUR RHEUMATOLOGIE | 2012年 / 71卷 / 07期

关键词：

Rheumatoid arthritis; Medical treatment; Disease-modifying antirheumatic drugs; Glucocorticoids; Biological agents; MODIFYING ANTIRHEUMATIC DRUGS; LOW-DOSE PREDNISOLONE; LOW DISEASE-ACTIVITY; GOOD INITIAL RESPONSE; DOUBLE-BLIND; RADIOGRAPHIC PROGRESSION; COMBINATION THERAPY; FOLLOW-UP; METHOTREXATE MONOTHERAPY; CLASSIFICATION CRITERIA;

D O I：

10.1007/s00393-012-1038-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Following the EULAR recommendations published in 2010 German guidelines for the medical treatment of rheumatoid arthritis were developed based on an update of the systematic literature search and expert consensus. Methotrexate is the standard treatment option at the time of diagnosis, preferably in combination with low dose glucocorticoids. Combined disease-modifying antirheumatic drugs (DMARD) therapy should be considered in patients not responding within 12 weeks. Treatment with biologicals should be initiated in patients with persistent high activity no later than 6 months after conventional treatment and in exceptional situations (e.g. early destruction or unfavorable prognosis) even earlier. If treatment with biologicals remains ineffective, changing to another biological is recommended after 3-6 months. In cases of long-standing remission a controlled reduction of medical treatment can be considered.

引用

页码：592 / +

页数：10

共 75 条

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