Revision exercise on the guideline for treatment of RA

2024 update of the APLAR recommendations for the treatment or rheumatoid arthritis – working group survey

This survey will assess which areas of RA treatment should be addressed by recommendations in the next update of the APLAR recommendations. We ask that you kindly complete the whole survey. There are options for you to provide your own suggestions of areas to address that were not covered in previous APLAR RA recommendations. In addition, we ask that you say whether each of the previous recommendation statements should be reconsidered given new evidence that may have emerged since the previous publications. The survey results will form the basis of research questions that will be use to draft new recommendations based on the results of a comprehensive literature search. Please complete and return this survey by Tuesday 1 August.

Thank you for participating in the development of the 2024 recommendations!

Please propose at least two (2) research questions not addressed in the previous RA treatment guideline update, that you think should be addressed in the new guideline update.

Two questions are the required minimum. *

Some sample questions:
· Should glucocorticoids be discontinued?
· What is the role of poor prognostic factors and disease activity for choice of treatment?
· When should we perform HZ vaccination?
· What are the recommended DMARDs in RA patients with pulmonary fibrosis?
· What is the treatment of RA with infection (eg. pneumonia, TB)?
· What should be the dose of hydroxychloroquine in treatment of RA?
· What is the efficacy of existing bDMARDs? Side-effect profile of existing bDMARDs?
· What is the efficacy of existing tsDMARDs? Side-effect profile of existing tsDMARDs?
· What to switch when patient fails a bDMARD or a tsDMARD?
· Reduce bDMARD first and then cDMARD/tDMARD, or vice versa, when sustained remission is achieved?
· When should we taper/discontinue DMARDs?
· What should be the duration of sustained remission before DMARD dose reduction?
· What are the emerging therapies for RA?

Please indicate in the boxes below which of the recommendations from the 2015 and 2018 RA treatment publications should be updated based on new evidence or changing circumstances.

 

2015 Recommendations

 

Section 1 – General RA treatment strategies

Section 2 – Role of NSAIDs (including COX-2 inhibitors)

Section 3 – Role of corticosteroids

Section 4 – Role of conventional DMARDs

Section 5 – Role of bDMARDs

Section 6 – Role of tofacitinib

2018 Recommendations