Canadian recommendations for use of methotrexate in patients with rheumatoid arthritis. Review uri icon

Overview

MeSH

  • Canada
  • Evidence-Based Medicine
  • Hematologic Diseases
  • Humans
  • Liver
  • Patient Preference
  • Rheumatology

MeSH Major

  • Antirheumatic Agents
  • Arthritis, Rheumatoid
  • Methotrexate
  • Practice Guidelines as Topic

abstract

  • To develop recommendations for the use of methotrexate (MTX) in patients with rheumatoid arthritis. Canadian rheumatologists who participated in the international 3e Initiative in Rheumatology (evidence, expertise, exchange) in 2007-2008 formulated 5 unique Canadian questions. A bibliographic team systematically reviewed the relevant literature on these 5 topics. An expert committee consisting of 26 rheumatologists from across Canada was convened, and a set of recommendations was proposed based on the results of systematic reviews combined with expert opinions using a nominal group consensus process. The 5 questions addressed drug interactions, predictors of response, strategies to reduce non-serious side effects, variables to assess clinical response, and incorporating patient preference into decision-making. The systematic review retrieved 93 pertinent articles; this evidence was presented to the expert committee during the interactive workshop. After extensive discussion and voting, a total of 9 recommendations were formulated: 2 on drug interactions, 1 on predictors of response, 2 on strategies to reduce non-serious side effects, 3 on variables to assess clinical response, and 1 on incorporating patient preferences into decision-making. The level of evidence and the strength of recommendations are reported. Agreement among panelists ranged from 85% to 100%. Nine recommendations pertaining to the use of MTX in daily practice were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement.

authors

publication date

  • July 2010

has subject area

  • Antirheumatic Agents
  • Arthritis, Rheumatoid
  • Canada
  • Evidence-Based Medicine
  • Hematologic Diseases
  • Humans
  • Liver
  • Methotrexate
  • Patient Preference
  • Practice Guidelines as Topic
  • Rheumatology

Research

keywords

  • Journal Article
  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.3899/jrheum.090978

PubMed ID

  • 20516029

Additional Document Info

start page

  • 1422

end page

  • 1430

volume

  • 37

number

  • 7