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Contemporary treatment principles for early rheumatoid arthritis: a consensus statement

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Contemporary treatment principles for early rheumatoid arthritis: a consensus statement. / Kiely, Patrick D. W.; Brown, Andrew K.; Edwards, Christopher J.; O'Reilly, David T.; Oestoer, Andrew J. K.; Quinn, Mark; Taggart, Allister; Taylor, Peter C.; Wakefield, Richard J.; Conaghan, Philip G.

In: Rheumatology, Vol. 48, No. 7, 07.2009, p. 765-772.

Research output: Contribution to journalArticlepeer-review

Harvard

Kiely, PDW, Brown, AK, Edwards, CJ, O'Reilly, DT, Oestoer, AJK, Quinn, M, Taggart, A, Taylor, PC, Wakefield, RJ & Conaghan, PG 2009, 'Contemporary treatment principles for early rheumatoid arthritis: a consensus statement', Rheumatology, vol. 48, no. 7, pp. 765-772. https://doi.org/10.1093/rheumatology/kep073

APA

Kiely, P. D. W., Brown, A. K., Edwards, C. J., O'Reilly, D. T., Oestoer, A. J. K., Quinn, M., Taggart, A., Taylor, P. C., Wakefield, R. J., & Conaghan, P. G. (2009). Contemporary treatment principles for early rheumatoid arthritis: a consensus statement. Rheumatology, 48(7), 765-772. https://doi.org/10.1093/rheumatology/kep073

Vancouver

Kiely PDW, Brown AK, Edwards CJ, O'Reilly DT, Oestoer AJK, Quinn M et al. Contemporary treatment principles for early rheumatoid arthritis: a consensus statement. Rheumatology. 2009 Jul;48(7):765-772. https://doi.org/10.1093/rheumatology/kep073

Author

Kiely, Patrick D. W. ; Brown, Andrew K. ; Edwards, Christopher J. ; O'Reilly, David T. ; Oestoer, Andrew J. K. ; Quinn, Mark ; Taggart, Allister ; Taylor, Peter C. ; Wakefield, Richard J. ; Conaghan, Philip G. / Contemporary treatment principles for early rheumatoid arthritis: a consensus statement. In: Rheumatology. 2009 ; Vol. 48, No. 7. pp. 765-772.

Bibtex - Download

@article{be00af64a4a14a7fac6aa1dffb484e9a,
title = "Contemporary treatment principles for early rheumatoid arthritis: a consensus statement",
abstract = "Methods. A group of practicing UK rheumatologists formulated contemporary management principles and clinical practice recommendations concerning both diagnosis and treatment. Areas of clinical uncertainty were documented, leading to research recommendations.Results. A fundamental concept governing treatment of RA is minimization of cumulative inflammation, referred to as the inflammationtime area under the curve (AUC). To achieve this, four core principles of management were identified: (i) detect and refer patients early, even if the diagnosis is uncertain: patients should be referred at the first suspicion of persistent inflammatory polyarthritis and rheumatology departments should provide rapid access to a diagnostic and prognostic service; (ii) treat RA immediately: optimizing outcomes with conventional DMARDs and biologics requires that effective treatment be started earlyideally within 3 months of symptom onset; (iii) tight control of inflammation in RA improves outcome: frequent assessments and an objective protocol should be used to make treatment changes that maintain low-disease activity/remission at an agreed target; (iv) consider the riskbenefit ratio and tailor treatment to each patient: differing patient, disease and drug characteristics require long-term monitoring of risks and benefits with adaptations of treatments to suit individual circumstances.Conclusion. These principles focus on effective control of the inflammatory process in RA, but optimal uptake may require changes in service provision to accommodate appropriate care pathways.",
keywords = "Rheumatoid arthritis, Early rheumatoid arthritis, DMARD, Corticosteroid, Anti-TNF therapy, Tight control, Step-down therapy, MODIFYING ANTIRHEUMATIC DRUGS, DIFFERENT TREATMENT STRATEGIES, RANDOMIZED CONTROLLED-TRIAL, PLACEBO-CONTROLLED TRIAL, DOUBLE-BLIND, COMBINATION THERAPY, CLINICAL REMISSION, DISEASE-ACTIVITY, ULTRASONOGRAPHIC ASSESSMENT, UNDIFFERENTIATED ARTHRITIS",
author = "Kiely, {Patrick D. W.} and Brown, {Andrew K.} and Edwards, {Christopher J.} and O'Reilly, {David T.} and Oestoer, {Andrew J. K.} and Mark Quinn and Allister Taggart and Taylor, {Peter C.} and Wakefield, {Richard J.} and Conaghan, {Philip G.}",
year = "2009",
month = jul,
doi = "10.1093/rheumatology/kep073",
language = "English",
volume = "48",
pages = "765--772",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "7",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Contemporary treatment principles for early rheumatoid arthritis: a consensus statement

AU - Kiely, Patrick D. W.

AU - Brown, Andrew K.

AU - Edwards, Christopher J.

AU - O'Reilly, David T.

AU - Oestoer, Andrew J. K.

AU - Quinn, Mark

AU - Taggart, Allister

AU - Taylor, Peter C.

AU - Wakefield, Richard J.

AU - Conaghan, Philip G.

PY - 2009/7

Y1 - 2009/7

N2 - Methods. A group of practicing UK rheumatologists formulated contemporary management principles and clinical practice recommendations concerning both diagnosis and treatment. Areas of clinical uncertainty were documented, leading to research recommendations.Results. A fundamental concept governing treatment of RA is minimization of cumulative inflammation, referred to as the inflammationtime area under the curve (AUC). To achieve this, four core principles of management were identified: (i) detect and refer patients early, even if the diagnosis is uncertain: patients should be referred at the first suspicion of persistent inflammatory polyarthritis and rheumatology departments should provide rapid access to a diagnostic and prognostic service; (ii) treat RA immediately: optimizing outcomes with conventional DMARDs and biologics requires that effective treatment be started earlyideally within 3 months of symptom onset; (iii) tight control of inflammation in RA improves outcome: frequent assessments and an objective protocol should be used to make treatment changes that maintain low-disease activity/remission at an agreed target; (iv) consider the riskbenefit ratio and tailor treatment to each patient: differing patient, disease and drug characteristics require long-term monitoring of risks and benefits with adaptations of treatments to suit individual circumstances.Conclusion. These principles focus on effective control of the inflammatory process in RA, but optimal uptake may require changes in service provision to accommodate appropriate care pathways.

AB - Methods. A group of practicing UK rheumatologists formulated contemporary management principles and clinical practice recommendations concerning both diagnosis and treatment. Areas of clinical uncertainty were documented, leading to research recommendations.Results. A fundamental concept governing treatment of RA is minimization of cumulative inflammation, referred to as the inflammationtime area under the curve (AUC). To achieve this, four core principles of management were identified: (i) detect and refer patients early, even if the diagnosis is uncertain: patients should be referred at the first suspicion of persistent inflammatory polyarthritis and rheumatology departments should provide rapid access to a diagnostic and prognostic service; (ii) treat RA immediately: optimizing outcomes with conventional DMARDs and biologics requires that effective treatment be started earlyideally within 3 months of symptom onset; (iii) tight control of inflammation in RA improves outcome: frequent assessments and an objective protocol should be used to make treatment changes that maintain low-disease activity/remission at an agreed target; (iv) consider the riskbenefit ratio and tailor treatment to each patient: differing patient, disease and drug characteristics require long-term monitoring of risks and benefits with adaptations of treatments to suit individual circumstances.Conclusion. These principles focus on effective control of the inflammatory process in RA, but optimal uptake may require changes in service provision to accommodate appropriate care pathways.

KW - Rheumatoid arthritis

KW - Early rheumatoid arthritis

KW - DMARD

KW - Corticosteroid

KW - Anti-TNF therapy

KW - Tight control

KW - Step-down therapy

KW - MODIFYING ANTIRHEUMATIC DRUGS

KW - DIFFERENT TREATMENT STRATEGIES

KW - RANDOMIZED CONTROLLED-TRIAL

KW - PLACEBO-CONTROLLED TRIAL

KW - DOUBLE-BLIND

KW - COMBINATION THERAPY

KW - CLINICAL REMISSION

KW - DISEASE-ACTIVITY

KW - ULTRASONOGRAPHIC ASSESSMENT

KW - UNDIFFERENTIATED ARTHRITIS

UR - http://www.scopus.com/inward/record.url?scp=67650138478&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kep073

DO - 10.1093/rheumatology/kep073

M3 - Article

VL - 48

SP - 765

EP - 772

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 7

ER -