Reumatología Clínica

ISSN: 1699-258X

Reumatología Clínica es el órgano oficial de difusión científica de la Sociedad Española de Reumatología (SER) y del Colegio Mexicano de Reumatología (CMR). Reumatología Clínica publica trabajos de investigación original, editoriales, revisiones, casos clínicos e imágenes. Los estudios publicados son principalmente clínicos y epidemiológicos pero también de investigación básica.

Reumatología Clínica ha recibido Factor de Impacto (JCR) por primera vez en 2023.
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Abstract
Keywords
Resumen
Palabras clave
Introduction
Methods
Study design and panel selection
Systematic literature review
Nominal group meeting
Delphi
Final consensus document
Results
Systematic literature review
R 1. in patients with active ra and inadequate response to mtx, this drug should be continued when starting a tnf inhibitor (le 1a; gr a; ga 100%), abt (le 2a; gr b; ga 100%), or rtx (le 1b-2a; gr b; ga 100%)
R 2.mtx should not be discontinued in patients with active ra and inadequate response to mtx who start il-6 inhibitors (le 1a; gr a; ga 91%)
R 3. mtx should not be discontinued in patients with active ra and inadequate response to mtx who start jaks inhibitors (le 1b; gr a; ga 91%)
R 4. when starting a combined therapy with mtx and bdmards in mtx-inadequate responders ra patients, it is recommended to continue with the same mtx doses (le 1b; gr a; ga 100%)
R 5. when combining mtx with tnf inhibitors, the dose of mtx should be of at least 10 mg/week (le 1b; gr a; ga 100%)
R 6. when starting a combined therapy with mtx and jaks inhibitors in mtx- inadequate responders ra patients, it is recommended to continue with the same mtx doses (le 1b; gr a; ga 100%)
R 7. in ra patients who have achieved and sustained the treatment goal, the panel recommends, as treatment strategy, to give priority to the de-escalation of the bdmards, which does not exclude mtx dose adjustments or even mtx withdrawal in some intolerant patients on il-6 inhibitors (le 5; gr d; ga 100%)
R 8. bdmards should be combined with mtx as the first csdmard choice, although other csdmards could be considered in case of mtx intolerance/contraindication (le 1b; gr a; ga 100%)
R 9. jaks inhibitors should be combined with mtx as the first csdmard choice, although other csdmards could be considered in case of mtx intolerance/contraindication (le 1b; gr a; ga 100%)
R 10. combination therapy of mtx with bdmards and tsdmards does not imply a different management of the standard of care for routine patient safety monitoring (le 5; gr d; ga 100%)
Discussion
Financing
Conflict of interest
Bibliografía

Vol. 18. Núm. 1.

Páginas 33-41 (Enero 2022)

Original Article

DOI: 10.1016/j.reuma.2020.08.003

Open Access

Experts document on methotrexate use in combined therapy with biological or targeted synthetic disease modifying drugs in patients with rheumatoid arthritis

Documento de expertos sobre el uso de terapia combinada de metotrexato con terapias biológicas o terapias dirigidas a pacientes con artritis reumatoide

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Jesús Tornero-Molinaa,

Autor para correspondencia

jtornero@sescam.org

Corresponding author.

, Mercedes Alperi-Lópezb, Ivan Castellvíc, Juan José de Agustín-de Orod, Alejandro Escuderoe, Rosario García-Vicuñaf, Miguel Ángel González-Gayg, Cristina Hidalgoh, Esteban Rubioi, Raimon Sanmartíj, Núria Casamirak, Jaime Calvo-Alénl

a Servicio de Reumatología, Hospital de Guadalajara, Guadalajara, Spain

b Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Spain

c Servicio de Reumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

d Servicio de Reumatología, Hospital Universitari Valld’Hebron, Barcelona, Spain

e Servicio de Reumatología, Hospital Universitario Reina Sofía, IMIBIC, Córdoba, Spain

f Servicio de Reumatología, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain

g Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Spain

h Servicio de Reumatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain

i Servicio de Reumatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain

j Servicio de Reumatología, Hospital Universitari Clínic, Barcelona, Spain

k Departamento Médico, Laboratorios Gebro Pharma, Barcelona, Spain

l Servicio de Reumatología, Hospital Universitario Araba, Vitoria-Gasteiz, Spain

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