Reumatología Clínica (English Edition)

ISSN: 2173-5743

Reumatología Clínica is the official publication of scientific Spanish Society of Rheumatology (SER) and the Mexican College of Rheumatology (CMR). Reumatología Clínica publishes original research papers, editorials, reviews, case reports and pictures. Published studies are primarily clinical and epidemiological research but also basic.

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Outline

Abstract
Keywords
Resumen
Palabras clave
Objective

Abstract
Keywords
Resumen
Palabras clave
Objective
Justification
Users
Methodology
Establishment of the working group
Target population
Development of recommendations
Scope
Exoneration
Introduction
Questions addressed
1. what are the general principles of management of ra?
2. what are the main treatment objectives?
3. what is the role of analgesics, nsaids, glucocorticoids and neuromodulators in the treatment of ra?
4. can you coadminister an nsaid or glucocorticoid with mtx?
5. when should treatment with a dmard be started?
6. what dmards should be considered as a first choice?
7. what studies are required before starting treatment with mtx and during follow-up?
8. is there evidence in the literature that parenteral administration of mtx is more effective than the oral administration?
9. is it safe to use mtx in patients with interstitial lung disease?
10. when should traditional dmards be combined?
11. is there evidence in the literature to pass from dmard combination therapy to monotherapy once the therapeutic response has been achieved?
12. what is the role of cyclophosphamide in the treatment of ra?
13. what is the role of anti-tnf treatment in ra?
14. in patients with active ra who are using anti-tnf, what is the wash-out period required before changing to another of a different mechanism of action?
15. when and how do changes between tnf to or from another mechanism of action have to be made?
16. what are the adverse events that should be considered when administering an anti-tnf?
17. what should be the therapeutic approach in patients with hepatitis b who are receiving anti-tnf therapy?
18. what should be the therapeutic approach in patients with tb who are receiving anti-tnf therapy?
19. what should be the therapeutic approach in patients with hiv who are receiving anti-tnf therapy?
20. what is the risk of neoplasia in patients with ra treated with anti-tnf?
21. what is the role of certolizumab in the treatment of ra?
22. what is the role of golimumab in the treatment of ra?
23. what is the role of rituximab, abatacept and tocilizumab in the treatment of ra?
24. is there any evidence that rituximab/tocilizumab/abatacept can be used as first-line therapy or as a first biologic in case of treatment failure to traditional dmards?
25. is there evidence that establishes that rituximab/tocilizumab/abatacept have a lower risk of tb compared with anti-tnf agents?
26. does the use of tofacitinib in the treatment of ra have support? has it demonstrated clinical and/or imaging benefit?
27. if a pregnancy is programmed in a patient with ra, how far in advance is suspending mtx, other traditional dmards and biological therapy recommended?
28. in those patients with disease activity during pregnancy, what traditional dmards can be recommended?
29. what traditional dmards may be used during lactation in patients with active disease?
30. is there evidence that a traditional dmard affects fertility?
31. what immunizations with live attenuated agents or inert agents are recommended in patients with ra? can they be applied during active disease?
32. in patients infected with the hepatitis b, c or hiv virus, which of traditional dmards and/or biological are advisable for use?
33. in patients with infections, which traditional and biologic dmards are indicated?
34. is it advisable to discontinue leflunomide, mtx and other traditional and biologic dmards before elective surgery and, if so, when should the drug be reinstituted?
35. in which biological therapies for latent tb is scrutiny recommended?
36. which patients should be considered for tb prophylactic treatment?
37. when should treatment with biological agents in patients receiving prophylaxis for tb be started?
General comment
Ethical responsibilities
Protection of persons and animals
Data confidentiality
Right to privacy and informed consent
Financing
Conflict of interest
Acknowledgements
Bibliography

Original Article

DOI: 10.1016/j.reumae.2013.10.006

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Update of the Mexican College of Rheumatology Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis

Actualización de la Guía Mexicana para el Tratamiento Farmacológico de la Artritis Reumatoide del Colegio Mexicano de Reumatología

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Mario H. Cardiela, Alejandro Díaz-Borjónb, Mónica Vázquez del Mercado Espinosac, Jorge Iván Gámez-Navad, Leonor A. Barile Fabrise, César Pacheco Tenaf, Luis H. Silveira Torreg, Virginia Pascual Ramosh, María Victoria Goycochea Roblesi, Jorge Enrique Aguilar Arreolaj, Verónica González Díazk, José Álvarez Nemegyeil, Laura del Carmen González-Lópezm, Mario Salazar Páramon, Margarita Portela Hernándezo, Zully Castro Colínp, Daniel Xavier Xibillé Friedmanq, Everardo Álvarez Hernándezr, Julio Casasola Vargass, Miguel Cortés Hernándezt..., Diana E. Flores-Alvaradou, Laura A. Martínez Martínezv, David Vega-Moralesw, Luis Felipe Flores-Suárezx, Gabriel Medrano Ramírezy, Antonio Barrera Cruzz, Adolfo García GonzálezA, Susana Marisela López LópezB, Alejandra Rosete ReyesC, Rolando Espinosa MoralesD,

Corresponding author

rolespi@yahoo.com

Corresponding author.

a Jefe de la Unidad de Investigación «Dr. Mario Alvizouri Muñoz», Hospital General «Dr. Miguel Silva», Secretaría de Salud de Michoacán, Morelia, Michoacán, Mexico

b Profesor Titular del Curso de Especialización en Medicina Interna, Hospital Ángeles Lomas/UNAM, Huixquilucan, Estado de México, Mexico

c Reumatólogo del Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jefa del Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

d Investigador de UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS. Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

e Reumatóloga y Doctora en Ciencias de la Salud, Jefa del departamento de Reumatología HE CMNSXXI IMSS, Profesora titular del curso de especialización en Reumatología, miembro titular del Sistema Nacional de Investigadores, Mexico City, Mexico

f Reumatólogo, Profesor-investigador de la Facultad de Medicina de la Universidad Autónoma de Chihuahua, Chihuahua, Mexico

g Médico adjunto, Profesor adjunto Curso de Reumatología, Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico

h Médico adscrito del Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

i Reumatóloga, investigadora titular A, adscrita a la Unidad de Investigación en Epidemiología Clínica del Hospital General Regional Núm. 1. «Dr. Carlos McGregor Sánchez Navarro», IMSS, Mexico City, Mexico

j Reumatólogo del Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

k Reumatóloga del Antiguo Hospital Civil de Guadalajara «Fray Antonio Alcalde», Guadalajara, Mexico

l Profesor Investigador de la escuela de Medicina de la Universidad Anáhuac-Mayab, Mérida, Yucatán, Mexico

m Reumatólogo del Hospital General Regional 110 del IMSS, Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

n Jefe de la División de Investigación de la UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS. Profesor del Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

o Adscrita al Departamento de Reumatología del Hospital de Especialidades del CMN SXXI, Mexico City, Mexico

p Adscrita al Departamento de Reumatología de HGZ 27 IMSS, Mexico City, Mexico

q Departamento de Reumatología, Hospital General de Cuernavaca «Dr. José G. Parres», SSM, Morelos, Mexico

r Reumatólogo, Hospital General de México, Mexico City, Mexico

s Reumatólogo, Hospital General de México, Mexico City, Mexico

t Medicina Interna-Reumatología, Profesor de Fisiología Humana, Facultad de Medicina, Universidad Autónoma de Estado de Morelos, Morelos, Mexico

u Profesora de Medicina Interna y Reumatología, Hospital Universitario «José E. González», Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico

v Investigadora titular, Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico

w Hospital Universitario «José E. González», Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico

x Reumatólogo, Jefe de la Clínica de Vasculitis Sistémicas Primarias, Instituto Nacional de Enfermedades Respiratorias, Investigador en Ciencias Médicas «D», Mexico City, Mexico

y Médico internista y reumatólogo, Adscrito al Servicio de Reumatología, Hospital General de México, Presidente del Consejo Mexicano de Reumatología, Mexico City, Mexico

z Reumatólogo, Maestro en Ciencias Médicas, Coordinador de Programas Médicos, adscrito a la División de Excelencia Clínica, área de Desarrollo de Guías de Práctica Clínica de la Coordinación de Unidades Médicas de Alta Especialidad del IMSS , Mexico City, Mexico

A Reumatólogo, Doctor en Ciencias Médicas, Hospital General de Zona IMSS, La Paz, Baja California Sur, Mexico

B Reumatóloga adscrita al servicio de Reumatología, Hospital Ángeles del Carmen, Guadalajara, Jalisco, Mexico

C Reumatóloga especializada en Fármaco-vigilancia, Jefe de operaciones Centro de Investigación en Farmacología y Biotecnología, Médica Sur, Mexico City, Mexico

D Profesor titular de Reumatología, UNAM, Jefe del Departamento de Reumatología, Instituto Nacional de Rehabilitación, Mexico City , Mexico

Article

Este artículo está disponible en español

Actualización de la Guía Mexicana para el Tratamiento Farmacológico de la Artritis Reumatoide del Colegio Mexicano de Reumatología

Mario H. Cardiel, Alejandro Díaz-Borjón, Mónica Vázquez del Mercado Espinosa, Jorge Iván Gámez-Nava, Leonor A. Barile Fabris, César Pacheco Tena, Luis H. Silveira Torre, Virginia Pascual Ramos, María Victoria Goycochea Robles, Jorge Enrique Aguilar Arreola, Verónica González Díaz, José Álvarez Nemegyei, Laura del Carmen González-López, Mario Salazar Páramo, Margarita Portela Hernández, Zully Castro Colín, Daniel Xavier Xibillé Friedman, Everardo Álvarez Hernández, Julio Casasola Vargas, Miguel Cortés Hernández, Diana E. Flores-Alvarado, Laura A. Martínez Martínez, David Vega-Morales, Luis Felipe Flores-Suárez, Gabriel Medrano Ramírez, Antonio Barrera Cruz, Adolfo García González, Susana Marisela López López, Alejandra Rosete Reyes, Rolando Espinosa Morales

10.1016/j.reuma.2013.10.006

Reumatol Clin. 2014;10:227-40

This article is available in English

Update of the Mexican College of Rheumatology Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis

10.1016/j.reumae.2013.10.006

Reumatol Clin. 2014;10:227-40

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Article

Actualización de la Guía Mexicana para el Tratamiento Farmacológico de la Artritis Reumatoide del Colegio Mexicano de Reumatología

Update of the Mexican College of Rheumatology Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis

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