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Reumatismo ; 62(1): 34-45, 2010.
Article in Italian | MEDLINE | ID: mdl-20390116

ABSTRACT

OBJECTIVE: To develop a set of national evidence-based recommendations for the use of Methotrexate (MTX) in daily clinical practice. METHODS: A panel of 37 Italian Rheumatologists reviewed 10 international recommendations formulated during the "3E (Evidence, Expertise, Exchange) initiative" for the year 2007-8, following a systematic literature search in Medline, Embase, Cochrane Library, and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts and the revision of selected papers and the appraisal of Oxford levels of evidence. Moreover, the same panel by the same methodology formulated further 5 recommendations on topics previously selected by Italian representatives to 3E initiative. The agreement about the set of proposed recommendations was stated by a consensus process and the potential impact on clinical practice was assessed. RESULTS: International Recommendations were analysed and changed when appropriate. In addition, 5 national recommendations were developed by identifying 6371 references, selecting and evaluating the 29 ones satisfying Evidence Based Medicine principles. CONCLUSIONS: A set of 15 national recommendations for the use of MTX in daily clinical practice was developed. These recommendations are evidence-based and integrate the expertise of a large panel of Italian rheumatologists.


Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid , Consensus , Methotrexate , Rheumatic Diseases , Humans , Antirheumatic Agents/administration & dosage , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Controlled Clinical Trials as Topic , Delphi Technique , Italy , Meta-Analysis as Topic , Methotrexate/therapeutic use , Rheumatic Diseases/drug therapy
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