Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

K Visser; W Katchamart; E Loza; J A Martinez-Lopez; C Salliot; J Trudeau; C Bombardier; L Carmona; D van der Heijde; J W J Bijlsma; D T Boumpas; H Canhao; C J Edwards; V Hamuryudan; T K Kvien; B F Leeb; E M Martín-Mola; H Mielants; U Müller-Ladner; G Murphy; Mikkel Østergaard; I A Pereira; C Ramos-Remus; G Valentini; J Zochling; M Dougados

doi:10.1136/ard.2008.094474

Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

K Visser, W Katchamart, E Loza, J A Martinez-Lopez, C Salliot, J Trudeau, C Bombardier, L Carmona, D van der Heijde, J W J Bijlsma, D T Boumpas, H Canhao, C J Edwards, V Hamuryudan, T K Kvien, B F Leeb, E M Martín-Mola, H Mielants, U Müller-Ladner, G MurphyMikkel Østergaard, I A Pereira, C Ramos-Remus, G Valentini, J Zochling, M Dougados

432 Citations (Scopus)

Abstract

OBJECTIVES: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.

METHODS: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed.

RESULTS: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases.

CONCLUSIONS: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	68
Issue number	7
Pages (from-to)	1086-93
Number of pages	8
ISSN	0003-4967
DOIs	https://doi.org/10.1136/ard.2008.094474
Publication status	Published - Jul 2009

Keywords

Abnormalities, Drug-Induced
Administration, Oral
Antirheumatic Agents
Drug Therapy, Combination
Evidence-Based Medicine
Female
Folic Acid
Humans
Long-Term Care
Male
Methotrexate
Preconception Care
Rheumatic Diseases
Risk Factors

Access to Document

10.1136/ard.2008.094474

Fingerprint

Dive into the research topics of 'Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative'. Together they form a unique fingerprint.

Cite this

Visser, K., Katchamart, W., Loza, E., Martinez-Lopez, J. A., Salliot, C., Trudeau, J., Bombardier, C., Carmona, L., van der Heijde, D., Bijlsma, J. W. J., Boumpas, D. T., Canhao, H., Edwards, C. J., Hamuryudan, V., Kvien, T. K., Leeb, B. F., Martín-Mola, E. M., Mielants, H., Müller-Ladner, U., ... Dougados, M. (2009). Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Annals of the Rheumatic Diseases, 68(7), 1086-93. https://doi.org/10.1136/ard.2008.094474

Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis : integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. / Visser, K; Katchamart, W; Loza, E et al.

In: Annals of the Rheumatic Diseases, Vol. 68, No. 7, 07.2009, p. 1086-93.

Research output: Contribution to journal › Journal article › Research › peer-review

Visser, K, Katchamart, W, Loza, E, Martinez-Lopez, JA, Salliot, C, Trudeau, J, Bombardier, C, Carmona, L, van der Heijde, D, Bijlsma, JWJ, Boumpas, DT, Canhao, H, Edwards, CJ, Hamuryudan, V, Kvien, TK, Leeb, BF, Martín-Mola, EM, Mielants, H, Müller-Ladner, U, Murphy, G, Østergaard, M, Pereira, IA, Ramos-Remus, C, Valentini, G, Zochling, J & Dougados, M 2009, 'Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative', Annals of the Rheumatic Diseases, vol. 68, no. 7, pp. 1086-93. https://doi.org/10.1136/ard.2008.094474

Visser K, Katchamart W, Loza E, Martinez-Lopez JA, Salliot C, Trudeau J et al. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Annals of the Rheumatic Diseases. 2009 Jul;68(7):1086-93. https://doi.org/10.1136/ard.2008.094474

Visser, K ; Katchamart, W ; Loza, E et al. / Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis : integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. In: Annals of the Rheumatic Diseases. 2009 ; Vol. 68, No. 7. pp. 1086-93.

@article{b1448d7e27be455bbdb2e235f2a8ad46,

title = "Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative",

abstract = "OBJECTIVES: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.METHODS: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed.RESULTS: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases.CONCLUSIONS: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.",

keywords = "Abnormalities, Drug-Induced, Administration, Oral, Antirheumatic Agents, Drug Therapy, Combination, Evidence-Based Medicine, Female, Folic Acid, Humans, Long-Term Care, Male, Methotrexate, Preconception Care, Rheumatic Diseases, Risk Factors",

author = "K Visser and W Katchamart and E Loza and Martinez-Lopez, {J A} and C Salliot and J Trudeau and C Bombardier and L Carmona and {van der Heijde}, D and Bijlsma, {J W J} and Boumpas, {D T} and H Canhao and Edwards, {C J} and V Hamuryudan and Kvien, {T K} and Leeb, {B F} and Mart{\'i}n-Mola, {E M} and H Mielants and U M{\"u}ller-Ladner and G Murphy and Mikkel {\O}stergaard and Pereira, {I A} and C Ramos-Remus and G Valentini and J Zochling and M Dougados",

year = "2009",

month = jul,

doi = "10.1136/ard.2008.094474",

language = "English",

volume = "68",

pages = "1086--93",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "B M J Group",

number = "7",

}

TY - JOUR

T1 - Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis

T2 - integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

AU - Visser, K

AU - Katchamart, W

AU - Loza, E

AU - Martinez-Lopez, J A

AU - Salliot, C

AU - Trudeau, J

AU - Bombardier, C

AU - Carmona, L

AU - van der Heijde, D

AU - Bijlsma, J W J

AU - Boumpas, D T

AU - Canhao, H

AU - Edwards, C J

AU - Hamuryudan, V

AU - Kvien, T K

AU - Leeb, B F

AU - Martín-Mola, E M

AU - Mielants, H

AU - Müller-Ladner, U

AU - Murphy, G

AU - Østergaard, Mikkel

AU - Pereira, I A

AU - Ramos-Remus, C

AU - Valentini, G

AU - Zochling, J

AU - Dougados, M

PY - 2009/7

Y1 - 2009/7

N2 - OBJECTIVES: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.METHODS: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed.RESULTS: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases.CONCLUSIONS: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.

AB - OBJECTIVES: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders.METHODS: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed.RESULTS: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases.CONCLUSIONS: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.

KW - Abnormalities, Drug-Induced

KW - Administration, Oral

KW - Antirheumatic Agents

KW - Drug Therapy, Combination

KW - Evidence-Based Medicine

KW - Female

KW - Folic Acid

KW - Humans

KW - Long-Term Care

KW - Male

KW - Methotrexate

KW - Preconception Care

KW - Rheumatic Diseases

KW - Risk Factors

U2 - 10.1136/ard.2008.094474

DO - 10.1136/ard.2008.094474

M3 - Journal article

C2 - 19033291

VL - 68

SP - 1086

EP - 1093

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 7

ER -