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001-es BibID:	BIBFORM096109
035-os BibID:	(WOS)000723328800001 (Scopus)85122302204
Első szerző:	Nagy György
Cím:	EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis / Nagy György, Roodenrijs Nadia M. T., Welsing Paco M. J., Kedves Melinda, Hamar Attila, van der Goes Marlies C., Kent Alison, Bakkers Margot, Pchelnikova Polina, Blaas Etienne, Senolt Ladislav, Szekanecz Zoltan, Choy Ernest H., Dougados Maxime, Jacobs Johannes W. G., Geenen Rinie, Bijlsma Johannes W. J., Zink Angela, Aletaha Daniel, Schoneveld Leonard, van Riel Piet, Dumas Sophie, Prior Yeliz, Nikiphorou Elena, Ferraccioli Gianfranco, Schett Georg, Hyrich Kimme L., Mueller-Ladner Ulf, Buch Maya H., McInnes Iain B., van der Heijde Désirée, van Laar Jacob M.
Dátum:	2022
ISSN:	0003-4967
Megjegyzések:	Objective To develop evidence-based European Alliance of Associations for Rheumatology (EULAR) points to consider (PtCs) for the management of difficultto-treat rheumatoid arthritis (D2T RA). Methods An EULAR Task Force was established comprising 34 individuals: 26 rheumatologists, patient partners and rheumatology experienced health professionals. Two systematic literature reviews addressed clinical questions around diagnostic challenges, and pharmacological and nonpharmacological therapeutic strategies in D2T RA. PtCs were formulated based on the identified evidence and expert opinion. Strength of recommendations (SoR, scale A?D: A typically consistent level 1 studies and D level 5 evidence or inconsistent studies) and level of agreement (LoA, scale 0?10: 0 completely disagree and 10 completely agree) of the PtCs were determined by the Task Force members. Results Two overarching principles and 11 PtCs were defined concerning diagnostic confirmation of RA, evaluation of inflammatory disease activity, pharmacological and non-pharmacological interventions, treatment adherence, functional disability, pain, fatigue, goal setting and self-efficacy and the impact of comorbidities. The SoR varied from level C to level D. The mean LoA with the overarching principles and PtCs was generally high (8.4?9.6). Conclusions These PtCs for D2T RA can serve as a clinical roadmap to support healthcare professionals and patients to deliver holistic management and more personalised pharmacological and non-pharmacological therapeutic strategies. High-quality evidence was scarce. A research agenda was created to guide future research.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk arthritis fibromyalgia inflammation rheumatoid ultrasonography
Megjelenés:	Annals Of The Rheumatic Diseases. - 81 : 1 (2022), p. 20-33. -
További szerzők:	Roodenrijs, Nadia M. T. Welsing, Paco M. J. Kedves Melinda Hamar Attila Béla (1990-) (általános orvos) van der Goes, Marlies C. Kent, Alison Bakkers, Margôt Pchelnikova, Polina Blaas, Etienne Senolt, Ladislav Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Choy, Ernest Dougados, Maxime Jacobs, Johannes W. G. Geenen, Rinie Bijlsma, Johannes W. Zink, Angela Aletaha, Daniel Schoneveld, Leonard van Riel, Piet Dumas, Sophie Prior, Yeliz Nikiphorou, Elena (reumatológus) Ferraccioli, Gianfranco Schett, Georg Hyrich, Kimme L. Mueller-Ladner, Ulf Buch, Maya H. McInnes, Iain B. van der Heijde, Désirée van Laar, Jacob M.
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001-es BibID:	BIBFORM088182
035-os BibID:	(WOS)000607296800019 (Scopus)85098069546
Első szerző:	Nagy György
Cím:	EULAR definition of difficult-to-treat rheumatoid arthritis / György Nagy, Nadia M. T. Roodenrijs, Paco M. J. Welsing, Melinda Kedves, Attila Hamar, Marlies C. van der Goes, Alison Kent, Margot Bakkers, Etienne Blaas, Ladislav Senolt, Zoltan Szekanecz, Ernest Choy, Maxime Dougados, Johannes W. G. Jacobs, Rinie Geenen, Hans W. J. Bijlsma, Angela Zink, Daniel Aletaha, Leonard Schoneveld, Piet van Riel, Loriane Gutermann, Yeliz Prior, Elena Nikiphorou, Gianfranco Ferraccioli, Georg Schett, Kimme L. Hyrich, Ulf Mueller-Ladner, Maya H. Buch, Iain B. McInnes, Désirée van der Heijde, Jacob M. van Laar
Dátum:	2021
ISSN:	0003-4967
Megjegyzések:	Background Despite treatment according to the current management recommendations, a significant proportion of patients with rheumatoid arthritis (RA) remain symptomatic. These patients can be considered to have 'difficult-to-treat RA'. However, uniform terminology and an appropriate definition are lacking. Objective The Task Force in charge of the "Development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis" aims to create recommendations for this underserved patient group. Herein, we present the definition of difficult-to-treat RA, as the first step. Methods The Steering Committee drafted a definition with suggested terminology based on an international survey among rheumatologists. This was discussed and amended by the Task Force, including rheumatologists, nurses, health professionals and patients, at a face-to-face meeting until sufficient agreement was reached (assessed through voting). Results The following three criteria were agreed by all Task Force members as mandatory elements of the definition of difficult-to-treat RA: (1) Treatment according to European League Against Rheumatism (EULAR) recommendation and failure of ?2 biological disease-modifying antirheumatic drugs (DMARDs)/targeted synthetic DMARDs (with different mechanisms of action) after failing conventional synthetic DMARD therapy (unless contraindicated); (2) presence of at least one of the following: at least moderate disease activity; signs and/or symptoms suggestive of active disease; inability to taper glucocorticoid treatment; rapid radiographic progression; RA symptoms that are causing a reduction in quality of life; and (3) the management of signs and/or symptoms is perceived as problematic by the rheumatologist and/or the patient. Conclusions The proposed EULAR definition for difficult-to-treat RA can be used in clinical practice, clinical trials and can form a basis for future research.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Annals Of The Rheumatic Diseases. - 80 : 1 (2021), p. 31-35. -
További szerzők:	Roodenrijs, Nadia M. T. Welsing, Paco M. J. Kedves Melinda Hamar Attila Béla (1990-) (általános orvos) Goes, Marlies C. van der Kent, Alison Bakkers, Margôt Blaas, Etienne Senolt, Ladislav Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Choy, Ernest Dougados, Maxime Jacobs, Johannes W. G. Geenen, Rinie Bijlsma, Johannes W. Zink, Angela Aletaha, Daniel Schoneveld, Leonard Riel, Piet van Gutermann, Loriane Prior, Yeliz Nikiphorou, Elena (reumatológus) Ferraccioli, Gianfranco Schett, Georg Hyrich, Kimme L. Mueller-Ladner, Ulf Buch, Maya H. McInnes, Iain B. Heijde, Désirée van der Laar, Jacob M. van
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001-es BibID:	BIBFORM075277
035-os BibID:	(WoS)000451780400011 (Scopus)85053158051
Első szerző:	Roodenrijs, Nadia M. T.
Cím:	Characteristics of difficult-to-treat rheumatoid arthritis : results of an international survey / Nadia M. T. Roodenrijs, Maria J. H. de Hair, Marlies C. van der Goes, Johannes W. G. Jacobs, Paco M. J. Welsing, Désirée van der Heijde, Daniel Aletaha, Maxime Dougados, Kimme L. Hyrich, Iain B. McInnes, Ulf Mueller-Ladner, Ladislav Senolt, Zoltan Szekanecz, Jacob M. van Laar, György Nagy, EULAR Task Force on development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis
Dátum:	2018
ISSN:	0003-4967
Megjegyzések:	Patients with difficult-to-treat rheumatoid arthritis (RA) remain symptomatic despite treatment according to current European League Against Rheumatism (EULAR) management recommendations. These focus on early phases of the disease and pharmacological management. We aimed to identify characteristics of difficult-to-treat RA and issues to be addressed in its workup and management that are not covered by current management recommendations. METHODS: An international survey was conducted among rheumatologists with multiple-choice questions on disease characteristics of difficult-to-treat RA. Using open questions, additional items to be addressed and items missing in current management recommendations were identified. RESULTS: 410 respondents completed the survey: 50% selected disease activity score assessing 28 joints >3.2 OR presence of signs suggestive of active disease as characteristics of difficult-to-treat RA; 42% selected fatigue; 48% selected failure to ?2 conventional synthetic disease-modifying antirheumatic drugs (DMARDs) AND ?2 biological/targeted synthetic DMARDs; 89% selected inability to taper glucocorticoids below 5 mg or 10 mg prednisone equivalent daily. Interfering comorbidities, extra-articular manifestations and polypharmacy were identified as important issues missing in current management recommendations. CONCLUSIONS: There is wide variation in concepts of difficult-to-treat RA. Several important issues regarding these patients are not addressed by current EULAR recommendations.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban disease activity rheumatoid Arthritis treatment
Megjelenés:	Annals Of The Rheumatic Diseases. - 77 (2018), p. 1705-1709. -
További szerzők:	Hair, Maria J. H. de Goes, Marlies C. van der Jacobs, Johannes W. G. Welsing, Paco M. J. Heijde, Désirée van der Aletaha, Daniel Dougados, Maxime Hyrich, Kimme L. McInnes, Iain B. Mueller-Ladner, Ulf Senolt, Ladislav Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Laar, Jacob M. van Nagy György EULAR Task Force on development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis
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