Switch or swap strategy in rheumatoid arthritis patients failing TNF inhibitors? Results of a modified Italian Expert Consensus.
Rheumatology (Oxford)
; 57(57 Suppl 7): vii42-vii53, 2018 10 01.
Article
em En
| MEDLINE
| ID: mdl-30289539
ABSTRACT
Objective:
To establish evidence-based and experts' opinion filtered statements on the optimal treatment choice between cycling (switch) and changing mode of action strategies (swap) in RA patients failing TNF inhibitors (TNFis).Methods:
The relevant question (switch vs swap) was rephrased into a research question according to the population, intervention, comparison and outcome (PICO) strategy, considering all the available scientific evidence published from the 2013 EULAR set of recommendations up to mid-January 2016. Final statements derived from the retrieved scientific evidence and experts' consensus, with eventual rephrasing through a Delphi method during a national consensus of Italian rheumatologists.Results:
From a total of 365 records, 12 studies were finally included. The final statements argued that, until head-to-head comparison data are available, switch and swap can be still considered suitable strategies in RA patients failing first TNFi, even though some data seem to lend more support to a different mode of action-targeted strategy.Conclusion:
After failure of first TNFi course, switch and swap can be currently considered as alternative suitable approaches in RA patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Fator de Necrose Tumoral alfa
/
Antirreumáticos
/
Medicina Baseada em Evidências
/
Consenso
Tipo de estudo:
Guideline
Limite:
Humans
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article