f12e01c93505513788348c982b1b32fb 298679.pdf f2e1f16070fa565566b4c4c2ae1f64b80e75b56d 298679.pdf c327bcfc97752df443f22c533563978cd032399dc23f50653a678a37ae527ca4 298679.pdf Title: Initial Treatment with Biological Therapy in Rheumatoid Arthritis Subject: Background: We aimed to analyse the effectiveness, efficiency, and safety of initial treatment with biological therapies in rheumatoid arthritis (RA). Methods: Qualitative study. A group of RA experts was selected. A scoping review in Medline was conducted to analyse the evidence of initial RA treatment with biological therapies. Randomised clinical trials were selected. Two reviewers analysed the articles and compiled the data, whose quality was assessed using the Jadad scale. The experts discussed the review’s findings and generated a series of general principles: Results: Seventeen studies were included. Most of the included patients were middle-aged women with early RA (1–7 months) and multiple poor prognostic factors. Initial treatment with TNF-alpha inhibitors combined with methotrexate (MTX) and an IL6R inhibitor (either in mono or combination therapy) is effective (activity, function, radiographic damage, quality of life), safe, and superior to MTX monotherapy in the short and medium term. In the long term, patients who received initial treatment with biologicals presented better results than those whose initial therapy was with MTX. Conclusions: Initial treatment of RA with biological therapies is effective, efficient, and safe in the short, medium, and long term, particularly for patients with poor prognostic factors. Keywords: rheumatoid arthritis; biologic therapy; initial treatment; narrative review; experts’ opinion Author: Jesús Tornero Molina, Blanca Hernández-Cruz and Héctor Corominas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Dec 21 10:25:33 2023 CET ModDate: Thu Dec 21 10:27:25 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 536204 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YUQEMP+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 LAXVUZ+VnURWPalladioL Type 1 Custom yes yes yes 16 0 CGBTUY+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 MDPXUY+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 LQSBID+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 51 0 IKKWKP+CMSY10 Type 1 Builtin yes yes yes 71 0 JJCLNN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 83 0 JJCLNO+PalatinoLinotype CID TrueType Identity-H yes yes yes 86 0 JJCLNP+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 JJCLOB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 95 0 JJCMFC+PalatinoLinotype TrueType MacRoman yes yes no 98 0 CRUZTT+VnURWPalladioL-Italic Type 1 Custom yes yes yes 130 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-07-24 02:41:03 CEST RepresentationInformation: 298679.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-07-22 11:33:35 CEST Size: 536204 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 378 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions and Future Directions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Initial Treatment with Biological Therapy in Rheumatoid Arthritis Author: Jesús Tornero Molina, Blanca Hernández-Cruz and Héctor Corominas Subject: Background: We aimed to analyse the effectiveness, efficiency, and safety of initial treatment with biological therapies in rheumatoid arthritis (RA). Methods: Qualitative study. A group of RA experts was selected. A scoping review in Medline was conducted to analyse the evidence of initial RA treatment with biological therapies. Randomised clinical trials were selected. Two reviewers analysed the articles and compiled the data, whose quality was assessed using the Jadad scale. The experts discussed the review’s findings and generated a series of general principles: Results: Seventeen studies were included. Most of the included patients were middle-aged women with early RA (1 7 months) and multiple poor prognostic factors. Initial treatment with TNF-alpha inhibitors combined with methotrexate (MTX) and an IL6R inhibitor (either in mono or combination therapy) is effective (activity, function, radiographic damage, quality of life), safe, and superior to MTX monotherapy in the short and medium term. In the long term, patients who received initial treatment with biologicals presented better results than those whose initial therapy was with MTX. Conclusions: Initial treatment of RA with biological therapies is effective, efficient, and safe in the short, medium, and long term, particularly for patients with poor prognostic factors. 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