Abstract
The German Society of Rheumatology approved new German guidelines for the sequential medical treatment of rheumatoid arthritis (RA) based on the European League Against Rheumatism (EULAR) recommendations for the management of RA published in 2010. An update of the EULAR systematic literature research was performed in Medline, Embase, and Cochrane databases. Meta-analyses, controlled trials, cohort studies, and registry data addressing traditional and biologic disease-modifying antirheumatic drugs, glucocorticoids, and treatment strategies published between January 2009 and August 2011 were included. Two reviewers independently evaluated and compared the additional data that had been published after the time limit set by the EULAR recommendations. A national guideline working group developed an adapted set of recommendations. The new German guidelines were accepted by vote using an informal Delphi approach. Twelve recommendations and the resulting updated treatment algorithm were developed and approved as a practical orientation for rheumatologists. These recommendations are based on a successive treatment with traditional and biologic disease-modifying drugs depending on the individual progress of the disease and distinct patient characteristics. The German guidelines have been developed on the basis of the internationally well-recognized EULAR recommendations. In addition, more recent evidence from a systematic literature research was considered. They have been developed and approved by a group of national experts aiming at guidance for rheumatologists to reach best medical practice.
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Acknowledgments
The German Society of Rheumatology financed the systematic literature search and the consensus meeting. It was supported by an unrestricted Grant “of the corporate members: Abbvie GmbH & Co.KG, Chugai Pharma Marketing Ltd., Pfizer Pharma GmbH, Roche Pharma AG, Sanofi-Aventis Deutschland GmbH, UCB Pharma GmbH.” The corresponding author points out that financial support had no impact on the content of the guidelines.
Conflict of interest
Dr. Albrecht reports grants from German Society of Rheumatology, during the conduct of the study; personal fees from Abbvie GmbH, outside the submitted work; and on behalf of all co-authors, the corresponding authors declares the following conflicts of interests: E.G.-I. declares that she has no potential conflicts of interests. The following authors declare a potential conflict of interest having received grant support and/or honoria for consultations, presentations, and/or travel expenses: K.A.: Abbvie; R.A.: Abbvie, BMS, GSK, Lilly, Mundipharma, Novartis, Pfizer, Roche, UCB; M.B.: Abbvie, BMS, MSD, Pfizer, Roche, UCB; C.B.: Abbvie, Amgen, GSK, Genzyme, MSD, Pfizer, Roche, Shire, Sanofi-Aventis; W.B.: AstraZeneca, MSD; J.B.: Abbvie, BMS, MSD, Mundipharma, Novartis, Pfizer, Roche, UCB, H.B.: Abbvie, BMS, Roche, Pfizer, UCB, Chugai, Amgen, Novartis, Morphosys, Celgene, Sanovi Aventis; G.R.B.: Abbvie, BMS, MSD, Pfizer, Roche, UCB; M.G.: Abbvie, Amgen, BMS, Chugai, Hexal, Merck, MSD, Mundipharma, Pfizer, Roche, SOBI und UCB; A.G.: Abbott, Chugai, MSD, Roche, UCB; H.K.: Abbvie, BMS, Chugai, Medac, MSD, Novartis, Pfizer, Roche, UCB; J.K.: Abbvie, Actelion, Berlin-Chemie, BMS, Chugai, GSK/HGS, Medac, Merck, MSD, Pfizer, Roche, Sanofi-Aventis, UCB; A.K.: Abbvie, BMS, Chugai, MSD, Pfizer, Roche, UCB; K.K.: Abbvie, BMS, MSD, Mundipharma, Pfizer, UCB, Roche; H.M.L.: Abbvie, Bristol-Myers Squibb, Chugai, GSK, Medac, Merck, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, UCB; B.M.: Abbvie, Berlin-Chemie, BMS, Biomarin, Chugai, Genzyme, GSK, MSD, Novartis, Nycomed, Pfizer, SOBI, UCB; U.M.L.: Abbvie, BMS, Chugai, MSD, Pfizer, Roche, UCB; H.N.: Abbvie, BMS, Chugai, Essex, Merck, MSD, Mundipharma, Pfizer, Roche, UCB, Wyeth; H.-G. P.: Abbvie, BMS, MSD, Pfizer und UCB; A.R.: Abbvie, BMS, Chugai, MSD, Novartis, Pfizer, Roche, UCB; C.S.: Abbvie, Chugai, GSK, MSD, Novartis, Pfizer, Roche, UCB, Wyeth; M.S.: Abbvie, Chugai, MSD, Pfizer, Roche, UCB; H.S.-K.: Abbvie, Actelion, Astra-Zeneca, Biotest, BMS, Chugai, Essex, Gilead, GSK, HGS, MSD, Medac, Merck, Mundai Pharma, Novartis, Nycomed, Savient, Pfizer, Roche, UCB, Wyeth; H.P.T.: Abbvie, BMS, Chugai, MSD, Roche; J.W.: Abbvie, BMS, Chugai, MSD, Pfizer, Roche, UCB. S.W.: Abbvie, Chugai, MSD, Novartis, Pfizer, Roche, UCB.
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Albrecht, K., Krüger, K., Wollenhaupt, J. et al. German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. Rheumatol Int 34, 1–9 (2014). https://doi.org/10.1007/s00296-013-2848-3
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DOI: https://doi.org/10.1007/s00296-013-2848-3