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2012 Brazilian Society of Rheumatology consensus for the treatment of rheumatoid arthritis

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2012 Brazilian Society of Rheumatology consensus for the treatment of rheumatoid arthritis

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Título 2012 Brazilian Society of Rheumatology consensus for the treatment of rheumatoid arthritis
Outro título Consenso 2012 da Sociedade Brasileira de Reumatologia para o tratamento da artrite reumatoide
Autor Pereira, Ivânio Alves
Mota, Licia Maria Henrique da
Cruz, Boris Afonso
Brenol, Claiton Viegas
Fronza, Lucila Stange Rezende
Bertolo, Manoel Barros
Freitas, Max Victor Carioca de
Silva, Nilzio Antonio da
Louzada Junior, Paulo
Giorgi, Rina Dalva Neubarth
Lima, Rodrigo Aires Corrêa
Pinheiro, Geraldo da Rocha Castelar
Abstract Objective: To elaborate recommendations for the treatment of rheumatoid arthritis in Brazil. Method: Literature review with articles’ selection based on evidence and the expert opinion of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology. Results and conclusions: 1) The therapeutic decision should be shared with the patient; 2) immediately after the diagnosis, a disease-modifying antirheumatic drug (DMARD) should be prescribed, and the treatment adjusted to achieve remission; 3) treatment should be conducted by a rheumatologist; 4) the initial treatment includes synthetic DMARDs; 5) methotrexate is the drug of choice; 6) patients who fail to respond after two schedules of synthetic DMARDs should be assessed for the use of biologic DMARDs; 7) exceptionally, biologic DMARDs can be considered earlier; 8) anti-TNF agents are preferentially recommended as the initial biologic therapy; 9) after therapeutic failure of a fi rst biologic DMARD, other biologics can be used; 10) cyclophosphamide and azathioprine can be used in severe extra-articular manifestations; 11) oral corticoid is recommended at low doses and for short periods of time; 12) non-steroidal anti-infl ammatory drugs should always be prescribed in association with a DMARD; 13) clinical assessments should be performed on a monthly basis at the beginning of treatment; 14) physical therapy, rehabilitation, and occupational therapy are indicated; 15) surgical treatment is recommended to correct sequelae; 16) alternative therapy does not replace traditional therapy; 17) family planning is recommended; 18) the active search and management of comorbidities are recommended; 19) the patient’s vaccination status should be recorded and updated; 20) endemic-epidemic transmissible diseases should be investigated and treated.
Contido em Revista brasileira de reumatologia. Campinas. Vol. 52, n. 2 (mar./abr. 2012), p. 474-495
Assunto Artrite reumatóide
Consenso
Terapêutica
[en] Antirheumatic agents
[en] Brazil
[en] Consensus
[en] Rheumatoid arthritis
[en] Therapy
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/146998
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