Methotrexate therapy for rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion

Joint, Bone, Spine : Revue Du Rhumatisme
Stephan PavyMaxime Dougados

Abstract

To develop clinical practice guidelines for the use of methotrexate in rheumatoid arthritis (RA), using the evidence-based approach and expert opinion. A scientific committee used a Delphi procedure to select five questions, which formed the basis for developing recommendations. Evidence providing answers to the five questions was sought in the Cochrane databases, PubMed, and proceedings of meetings of the French Society for Rheumatology, European League Against Rheumatism, and American College of Rheumatology. Using this evidence, a group of rheumatologists developed and validated the recommendations. For each recommendation, the level of evidence and the extent of agreement among experts were specified. The recommendations were as follows: 1: The starting dosage for methotrexate in patients with RA should not be less than 10 mg/week and should be determined based on disease severity and patient-related factors; 2: When a patient with RA shows an inadequate response to methotrexate, the dosage should be increased at intervals of 6 weeks, up to 20 mg/week, according to tolerance and patient-related factors; 3: When starting methotrexate treatment in a patient with RA, preference should be given to the oral route. A switch to th...Continue Reading

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Citations

Aug 7, 2013·Annals of the Rheumatic Diseases·Paul EmeryTom W J Huizinga
May 15, 2007·Journal of Clinical Pathology·W S A SmellieA J McCulloch
Dec 3, 2010·Journal of Crohn's & Colitis·Giovanni CasellaGabrio Bassotti
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Oct 30, 2012·Immunology and Allergy Clinics of North America·Keith C Meyer, Jennifer Bierach
Apr 5, 2011·Joint, Bone, Spine : Revue Du Rhumatisme·Christoph GräniThomas Langenegger
Apr 7, 2011·Thérapie·Marie-Clémence VerdierDanièle Bentué-Ferrer
Mar 30, 2011·Joint, Bone, Spine : Revue Du Rhumatisme·Gaël MouterdeThierry Schaeverbeke
Aug 10, 2010·Clinics in Chest Medicine·Keith C MeyerRobert Baughman
Jun 18, 2010·Joint, Bone, Spine : Revue Du Rhumatisme·Martin SoubrierJean-Michel Ristori
Jun 30, 2009·Joint, Bone, Spine : Revue Du Rhumatisme·Johannes W J Bijlsma, Johannes W G Jacobs
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Jun 27, 2014·International Journal of Rheumatic Diseases·Alireza KhabbaziArezu Poormohammad
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May 3, 2018·Modern Rheumatology·Hideto KamedaUNKNOWN Japan College of Rheumatology subcommittee on the guideline for the use of methotrexate in patients with rheumatoid arthriti

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