2024 update of the recommendations of the French Society of Rheumatology for the diagnosis and management of patients with rheumatoid arthritis - 24/11/24
Graphical abstract |
Highlights |
• | The topics addressed in this update are: (1) diagnosis and therapeutic management of RA, (2) management of people at risk of RA, (3) management of RA-related interstitial lung disease (RA-ILD). |
• | The general principles emphasize the importance of a shared decision between the rheumatologist and patient and the need for comprehensive management, both drug and non-drug, for people with RA or at risk of RA development. |
• | In terms of diagnosis, the recommendations stress the importance of clinical arthritis and in its absence, the risk factors for progression to RA. |
• | The recommendations incorporate recent data on the cardiovascular and neoplastic risk profile of Janus kinase inhibitors. |
• | The recommendations highlight the need for high-resolution CT scan in the presence of pulmonary symptoms. RA-ILD management requires collaboration between rheumatologists and pulmonologists, and is based on controlling disease activity. |
Abstract |
The French Society of Rheumatology recommendations for managing rheumatoid arthritis (RA) has been updated by a working group of 21 rheumatology experts, 4 young rheumatologists and 2 patient association representatives on the basis of the 2023 version of the European Alliance of Associations for Rheumatology (EULAR) recommendations and systematic literature reviews. Two additional topics were addressed: people at risk of RA development and RA-related interstitial lung disease (RA-ILD). Four general principles and 19 recommendations were issued. The general principles emphasize the importance of a shared decision between the rheumatologist and patient and the need for comprehensive management, both drug and non-drug, for people with RA or at risk of RA development. In terms of diagnosis, the recommendations stress the importance of clinical arthritis and in its absence, the risk factors for progression to RA. In terms of treatment, the recommendations incorporate recent data on the cardiovascular and neoplastic risk profile of Janus kinase inhibitors. With regard to RA-ILD, the recommendations highlight the importance of clinical screening and the need for high-resolution CT scan in the presence of pulmonary symptoms. RA-ILD management requires collaboration between rheumatologists and pulmonologists. The treatment strategy is based on controlling disease activity with methotrexate or targeted therapies (mainly abatacept or rituximab). The prescription for anti-fibrotic treatment should be discussed with a pulmonologist with expertise in RA-ILD.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Rheumatoid arthritis, People at risk of rheumatoid arthritis, Interstitial lung disease, Therapeutics, Targeted therapies, Biologics, DMARD, JAK inhibitors, Management, Recommendations for clinical practice
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Vol 91 - N° 6
Articolo 105790- Dicembre 2024 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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