RD's Choice of DMARDS after failure of MTX | Arthritis Information

 

Fautrel B et al. – A simple and easy-to-use decision tree as presented in this study, which is based on rheumatologists' preferences for therapy after failure of MTX therapy in RA treatment may guide rheumatologists to choose a second-line disease-modifying antirheumatic drug (DMARD).

Methods

• A survey of rheumatologists' preferences for the choice of a second-line DMARD after inadequate response with MTX therapy in RA
• 36 rheumatologists stated their preferences for RA treatment
• 54 vignettes were derived varying by RF or anti-CCP Ab presence, swollen joint count, DAS-28, and structural damage
• Respondents stated their preference among 5 therapeutic options:
  • MTX continuation
  • Switch to another conventional DMARD
  • Addition of another conventional DMARD
  • Addition of anakinra or
  • Addition of a TNF blocker
• Presentation by pairs yielded 10 combinations of strategies for each variant, totaling 540 vignettes
• Participants evaluated a random sample of 180 vignettes

Results

• Responses of 33 rheumatologists were analyzable
• Therapeutic preferences corresponded to the top-ranked options:
  • for pts with mild or moderately active RA either a switch or step-up strategy to another conventional DMARD
  • TNF blockers for RA pts with high disease activity or progressive structural damage
• On the basis of these preferences, a simple decision tree for use in daily clinical practice was developed

http://www3.interscience.wiley.com/journal/122290984/abstract?CRETRY=1&SRETRY=0

Lynn, could you send that link again?  I got a retry message.  Thanks  Try this....It should help you link to the article.   This is the **perfect** think for me to take to my RD.  You are a mind reader!  (Did I say thank-you?)  RITUXAN RITUXAN RITUXAN RITUXAN RITUXAN [QUOTE=waddie]  This is the **perfect** think for me to take to my RD.  You are a mind reader!  (Did I say thank-you?)  [/QUOTE]