Recommendations for the Use of Methotrexate in Psoriatic Arthritis/Recomendaciones sobre el uso de metotrexato en pacientes con artritis psoriasica
- Canete, Juan D.
Garcia Llorente, Jose Francisco
Pinto, Jose A.
- Reumatologia clinica. July 2018, Vol. 14 Issue 4, 183
- Publication Date:
- To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.reumae.2017.08.001 Byline: Juan D. Canete (a), Rafael Ariza-Ariza (b), Sagrario Bustabad (c), Concepcion Delgado (d), Cristina Fernandez-Carballido (e), Jose Francisco Garcia Llorente (f), Estibaliz Loza [firstname.lastname@example.org] (g,*), Carlos Montilla (h,i), Antonio Naranjo (j,k), Jose A. Pinto (l), Ruben Queiro (m), Julio Ramirez (a), Jesus Tornero-Molina (n,o) Keywords Methotrexate; Psoriatic arthritis; Recommendations Abstract Objectives To develop recommendations for the management of methotrexate (MTX) in psoriatic arthritis (PsA), based on best evidence and experience. Methods A group of 12 experts on MTX use was selected. The coordinators formulated 14 questions about the use of MTX in PsA patients (indications, efficacy, safety and cost-effectiveness). A systematic review was conducted to answer the questions. Using this information, inclusion and exclusion criteria were established, as were the search strategies (Medline, EMBASE and the Cochrane Library were searched). Two different reviewers selected the articles. Evidence tables were created. At the same time, European League Against Rheumatism and American College of Rheumatology abstracts were evaluated. Based on this evidence, the coordinators proposed 12 preliminary recommendations that the experts discussed and voted on in a nominal group meeting. The level of evidence and grade of recommendation were established using the Oxford Center for Evidence Based Medicine and the level of agreement with the Delphi technique (two rounds). Agreement was established if at least 80% of the experts voted yes (yes/no). Results A total of 12 preliminary recommendations on the use of MTX were proposed, 9 of which were accepted. One was included in a different recommendation and other two were not voted on and were thereafter clarified in the main text. Conclusions These recommendations aim to answer frequent questions and help in decision making strategies when treating PsA patients with MTX. Author Affiliation: (a) Servicio de Reumatologia, Hospital Clinic de Barcelona e IDIBAPS, Barcelona, Spain (b) Departamento de Reumatologia, Hospital Universitario Virgen Macarena, Sevilla, Spain (c) Departamento de Reumatologia, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain (d) Departamento de Reumatologia, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain (e) Departamento de Reumatologia, Hospital General Universitario de Elda, Elda, Alicante, Spain (f) Departamento de Reumatologia, Hospital de Galdakao-Usansolo, Galdacano, Vizcaya, Spain (g) Instituto de Salud Musculoesqueletica, Madrid, Spain (h) Departamento de Reumatologia, Hospital Universitario de Salamanca, Salamanca, Spain (i) Instituto de Investigacion Biomedica de Salamanca (IBSAL), Salamanca, Spain (j) Departamento de Reumatologia, Hospital Universitario de Gran Canaria Dr. Negrin, Gran Canaria, Spain (k) Universidad de Las Palmas de Gran Canaria, Gran Canaria, Spain (l) Departamento de Reumatologia, Complejo Hospitalario Universitario de A Coruna, La Coruna, Spain (m) Departamento de Reumatologia, Hospital Universitario Central de Asturias, Oviedo, Spain (n) Departamento de Reumatologia, Hospital de Guadalajara, Guadalajara, Spain (o) Departamento de Medicina y Especialidades Medicas, Universidad de Alcala, Madrid, Spain * Corresponding author. Article History: Received 5 April 2017; Accepted 10 August 2017 (footnote)[white star] Please cite this article as: Canete JD, Ariza-Ariza R, Bustabad S, Delgado C, Fernandez-Carballido C, Garcia Llorente JF, et al. Recomendaciones sobre el uso de metotrexato en pacientes con artritis psoriasica. Reumatologia Clinica. 2018;14:183--190.
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