System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 42507767 DOI: 10.1097/RHU.0000000000002391

Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis: 2025 Update Part I.

J Clin Rheumatol

Authors: Emilce E Schneeberger, Gustavo Citera, Natalia V Zamora, Enrique R Soriano Guppy, María V Martire, Eduardo F Mysler, Silvia B Papasidero, Rodrigo N García Salinas, Guillermo A Berbotto, Gustavo C Casado, Carla A Gobbi, Hernán Maldonado Ficco, Rodolfo S Pérez Alamino, Bernardo Pons-Estel, Javier E Rosa, Darío Scublinsky, Anastasia Secco, José L Velasco Zamora, María A Correa, Alejandra M Babini, Edson J Velozo, Cecilia A Asnal, Tomás Cazenave, Alejandro Martínez Muñóz, María C de la Vega

Affiliations

  • Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Ciudad Autónoma de Buenos Aires.
  • Rheumatology Section, Hospital General de Agudos San José, Pergamino.
  • Research Unit of the Argentine Society of Rheumatology (UNISAR), Ciudad Autónoma de Buenos Aires.
  • Rheumatology Section, Internal Medicine Service, Hospital Italiano and Universidad del Hospital Italiano, Ciudad Autonóma de Buenos Aires.
  • Rheumatology Section, Hospital San Roque, Gonnet.
  • Immunology Department, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata.
  • Rheumatology Section, Organización Médica de Investigación, Ciudad Autónoma de Buenos Aires.
  • Rheumatology Section, Hospital General de Agudos Dr E Tornú, Ciudad Autónoma de Buenos Aires.
  • Arthritis and Spondyloarthritis Unit, Hospital Italiano La Plata, La Plata, Buenos Aires.
  • Rheumatology Service, Hospital Escuela Eva Perón, Granadero Baigorria, Santa Fe.
  • Rheumatology Service, Hospital Militar Central, Ciudad Autónoma de Buenos Aires, Buenos Aires.
  • Rheumatology Service, Hospital Córdoba.
  • Department of Internal Medicine I, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.
  • Rheumatology Section, Hospital San Antonio de Padua, Río Cuarto, Córdoba.
  • Rheumatology Section, Hospital Avellaneda, Tucumán.
  • Grupo Oroño, Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe.
  • Rheumatology Section, Hospital General de Agudos Dr Juan A Fernández, Ciudad Autónoma de Buenos Aires.
  • Pharmacology Department, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires.
  • Rheumatology Section, Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires.
  • Instituto de Investigaciones Clínicas Quilmes, Quilmes, Buenos Aires.
  • Rheumatology Service, Hospital Italiano Córdoba, Córdoba.
  • Rheumatology Unit, Sanatorio y Universidad Adventista del Plata, Puiggari, Entre Ríos.
  • Rheumatology Service, Hospital Alemán, Ciudad Autónoma de Buenos Aires.
  • Rheumatology Section, Centro Schejtman, San Miguel.
  • Rheumatology Section, Hospital General de Agudos Dr Cosme Argerich, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.

Abstract

BACKGROUND

Rheumatoid arthritis (RA) is a severe, systemic chronic rheumatic disease, and it is important for each country and/or region to develop management recommendations adapted to its needs and resources.

OBJECTIVES

To update the Argentine treatment recommendations for the management of patients with RA.

METHODS

The working group comprised a principal investigator, 8 methodologists and 23 expert rheumatologists. Seventy-one PICO questions were developed. A systematic literature review (SLR) was conducted using the Medline (PubMed), LILACS, and Cochrane Library databases. Grey literature was also searched. The evidence was appraised using the GRADE methodology. Voting was anonymous and conducted virtually, and recommendations required at least 70% agreement to achieve consensus.

RESULTS

A total of 21 recommendations were developed, addressing Mediterranean diet, subcutaneous versus oral methotrexate, and therapeutic strategies across different clinical scenarios, including: csDMARD naive, inadequate response (IR) to csDMARD, IR to b/tsDMARD (cycling versus swapping), monotherapy, tapering in patients with sustained remission, and management of patients with concomitant interstitial lung disease or rheumatoid vasculitis. In most cases, the levels of evidence and degrees of agreement were moderate.

CONCLUSIONS

These recommendations are intended to be a practical tool to assist rheumatologists in making the most appropriate treatment decisions for their patients.

MeSH

Rheumatology, Arthritis, Rheumatologists, Rheumatic Diseases, Arthritis, Rheumatoid, Therapeutics