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.

Hdl Handle:
http://hdl.handle.net/10147/200982
Title:
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.
Authors:
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; Martín-Mola, E M; Mielants, H; Müller-Ladner, U; Murphy, G; Østergaard, M; Pereira, I A; Ramos-Remus, C; Valentini, G; Zochling, J; Dougados, M
Affiliation:
Leiden University Medical Center, Department of Rheumatology, Leiden, The Netherlands. k.visser@lumc.nl
Citation:
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. 2009, 68 (7):1086-93 Ann. Rheum. Dis.
Publisher:
BMJ Publishing Group Ltd
Journal:
Annals of the rheumatic diseases
Issue Date:
Jul-2009
URI:
http://hdl.handle.net/10147/200982
DOI:
10.1136/ard.2008.094474
PubMed ID:
19033291
Additional Links:
http://ard.bmj.com/content/68/7/1086.full.pdf+html; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689523/pdf/ard-68-07-1086.pdf
Abstract:
To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.; 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.; 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.; 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.
Item Type:
Article
Language:
en
Description:
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.
MeSH:
Abnormalities, Drug-Induced; Administration, Oral; Antirheumatic Agents; Drug Therapy, Combination; Evidence-Based Medicine; Female; Folic Acid; Humans; Long-Term Care; Male; Methotrexate; Preconception Care; Rheumatic Diseases; Risk Factors
ISSN:
1468-2060

Full metadata record

DC FieldValue Language
dc.contributor.authorVisser, Ken
dc.contributor.authorKatchamart, Wen
dc.contributor.authorLoza, Een
dc.contributor.authorMartinez-Lopez, J Aen
dc.contributor.authorSalliot, Cen
dc.contributor.authorTrudeau, Jen
dc.contributor.authorBombardier, Cen
dc.contributor.authorCarmona, Len
dc.contributor.authorvan der Heijde, Den
dc.contributor.authorBijlsma, J W Jen
dc.contributor.authorBoumpas, D Ten
dc.contributor.authorCanhao, Hen
dc.contributor.authorEdwards, C Jen
dc.contributor.authorHamuryudan, Ven
dc.contributor.authorKvien, T Ken
dc.contributor.authorLeeb, B Fen
dc.contributor.authorMartín-Mola, E Men
dc.contributor.authorMielants, Hen
dc.contributor.authorMüller-Ladner, Uen
dc.contributor.authorMurphy, Gen
dc.contributor.authorØstergaard, Men
dc.contributor.authorPereira, I Aen
dc.contributor.authorRamos-Remus, Cen
dc.contributor.authorValentini, Gen
dc.contributor.authorZochling, Jen
dc.contributor.authorDougados, Men
dc.date.accessioned2012-01-09T16:41:01Z-
dc.date.available2012-01-09T16:41:01Z-
dc.date.issued2009-07-
dc.identifier.citationMultinational 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. 2009, 68 (7):1086-93 Ann. Rheum. Dis.en
dc.identifier.issn1468-2060-
dc.identifier.pmid19033291-
dc.identifier.doi10.1136/ard.2008.094474-
dc.identifier.urihttp://hdl.handle.net/10147/200982-
dc.descriptionOBJECTIVES: 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.en
dc.description.abstractTo develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.-
dc.description.abstract751 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.-
dc.description.abstractA 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.-
dc.description.abstractTen 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.-
dc.language.isoenen
dc.publisherBMJ Publishing Group Ltden
dc.relation.urlhttp://ard.bmj.com/content/68/7/1086.full.pdf+htmlen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689523/pdf/ard-68-07-1086.pdfen
dc.subject.meshAbnormalities, Drug-Induced-
dc.subject.meshAdministration, Oral-
dc.subject.meshAntirheumatic Agents-
dc.subject.meshDrug Therapy, Combination-
dc.subject.meshEvidence-Based Medicine-
dc.subject.meshFemale-
dc.subject.meshFolic Acid-
dc.subject.meshHumans-
dc.subject.meshLong-Term Care-
dc.subject.meshMale-
dc.subject.meshMethotrexate-
dc.subject.meshPreconception Care-
dc.subject.meshRheumatic Diseases-
dc.subject.meshRisk Factors-
dc.titleMultinational 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.en
dc.typeArticleen
dc.contributor.departmentLeiden University Medical Center, Department of Rheumatology, Leiden, The Netherlands. k.visser@lumc.nlen
dc.identifier.journalAnnals of the rheumatic diseasesen
dc.description.provinceMunster-

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