TY - JOUR T1 - Biologic Disease-modifying Antirheumatic Drug Attributes in the First Lines of Treatment of Rheumatoid Arthritis. 2015 ACORDAR Project JO - Reumatología Clínica (English Edition) T2 - AU - Muñoz-Fernández,Santiago AU - Bustabad Reyes,María Sagrario AU - Calvo Alén,Jaime AU - Castaño Sánchez,Manuel AU - Chamizo Carmona,Eugenio AU - Corominas,Héctor AU - Fernández-Llanio Comella,Nagore AU - Hidalgo Calleja,María Cristina AU - Pérez Venegas,José Javier AU - Rodríguez Heredia,José Manuel AU - Romero Yuste,Susana María AU - Ruiz-Esquide Torino,Virginia SN - 21735743 M3 - 10.1016/j.reumae.2016.10.005 DO - 10.1016/j.reumae.2016.10.005 UR - https://www.reumatologiaclinica.org/en-biologic-disease-modifying-antirheumatic-drug-attributes-articulo-S2173574317301454 AB - ObjectiveTo date, between 17% and 35% of patients with rheumatoid arthritis (RA) do not respond as expected to the initial biological therapy. The objective of this project is to recognize and weigh the attributes of biologic DMARD (bDMARD) to identify the most appropriate for each case, in the first lines of treatment of RA (after inadequate response to at least one synthetic DMARD or previous bDMARD). MethodsTo recognize the possible attributes that could define the bDMARD, we performed a systematic search of the literature that recognized the possible attributes involving general aspects, pharmacology, efficacy, safety, management, and cost. Then a Delphi process was conducted with two rounds among a group of selected expert rheumatologists in the management of RA indicating the degree of agreement with the attributes identified in the literature. The project was completed between February and September 2015, indicating the degree of importance that was ascribed to each attribute. Two criteria were applied to determine the consistency of results: (1) based on the median and interquartile range; and (2) on the simultaneous compliance with mean, median, standard deviation, interquartile range and coefficient of variation. The agreement and final ratification of the expert panel were also determined. ResultsEighty-three Spanish rheumatologists participated and completed both rounds of the Delphi process. In no case was the importance of the 77 attributes identified considered to be low; 75 of 77 (97.4%) were considered highly important and 76 of 77 (98.7%) were ratified. Fifteen attributes had the support of 100% of the working group. ConclusionsThere was a high degree of agreement concerning the selected attributes. Fifteen of them had the support of 100% of the working group and could be considered the definition of the ideal bDMARD in the first lines of RA treatment. ER -