Journal article
Authors list: Visser, K.; Katchamart, W.; Loza, E.; Martinez-Lopez, J. A.; Salliot, C.; Trudeau, J.; Bombardier, C.; Carmona, L.; van der Heijde, D.; Bijlsma, J. W. J.; Boumpas, D. T.; Canhao, H.; Edwards, C. J.; Hamuryudan, V.; Kvien, T. K.; Leeb, B. F.; Martin-Mola, E. M.; Mielants, H.; Mueller-Ladner, U.; Murphy, G.; Ostergaard, M.; Pereira, I. A.; Ramos-Remus, C.; Valentini, G.; Zochling, J.; Dougados, M.
Publication year: 2009
Pages: 1086-1093
Journal: Annals of the Rheumatic Diseases
Volume number: 68
Issue number: 7
ISSN: 0003-4967
eISSN: 1468-2060
Open access status: Hybrid
DOI Link: https://doi.org/10.1136/ard.2008.094474
Publisher: Elsevier
Objectives: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. Methods: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases. Conclusions: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.
Abstract:
Citation Styles
Harvard Citation style: Visser, K., Katchamart, W., Loza, E., Martinez-Lopez, J., Salliot, C., Trudeau, J., et al. (2009) Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative, Annals of the Rheumatic Diseases, 68(7), pp. 1086-1093. https://doi.org/10.1136/ard.2008.094474
APA Citation style: Visser, K., Katchamart, W., Loza, E., Martinez-Lopez, J., Salliot, C., Trudeau, J., Bombardier, C., Carmona, L., van der Heijde, D., Bijlsma, J., Boumpas, D., Canhao, H., Edwards, C., Hamuryudan, V., Kvien, T., Leeb, B., Martin-Mola, E., Mielants, H., Mueller-Ladner, U., ...Dougados, M. (2009). Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Annals of the Rheumatic Diseases. 68(7), 1086-1093. https://doi.org/10.1136/ard.2008.094474
Keywords
CLINICAL-TRIAL; COMBINATION THERAPY; DOUBLE-BLIND; ELECTRON-MICROSCOPIC ANALYSIS; FOLINIC ACID; LIVER-BIOPSY SAMPLES; LOW-DOSE METHOTREXATE; MODIFYING ANTIRHEUMATIC DRUGS; PLUS METHOTREXATE; PSORIATIC-ARTHRITIS
