RT Journal Article
T1 REDOSER project: optimising biological therapy dose for rheumatoid arthritis and spondyloarthritis patients
A1 Gonzalez-Alvaro, Isidoro
A1 Blasco, Antonio J.
A1 Lazaro, Pablo
A1 Sanchez-Piedra, Carlos
A1 Almodovar, Raquel
A1 Bachiller-Corral, Javier
A1 Balsa, Alejandro
A1 Caliz, Rafael
A1 Candelas, Gloria
A1 Fernandez-Carballido, Cristina
A1 Garcia-Aparicio, Angel
A1 Garcia-Magallon, Blanca
A1 Garcia-Vicuna, Rosario
A1 Gomez-Centeno, Antonio
A1 Ortiz, Ana M.
A1 Sanmarti, Raimon
A1 Sanz, Jesus
A1 Tejera, Beatriz
K1 Pharmaceutical science
K1 Evidence-based medicine
K1 Medicine
K1 Low disease-activity
K1 Ankylosing-spondylitis
K1 Long-term
K1 Appropriateness method
K1 Psoriatic-arthritis
K1 Clinical-practice
K1 Metaanalysis
K1 Remission
K1 Efficacy
K1 Safety
AB Background: Reducing the dose of biological therapy (BT) when patients with immune-mediated arthritis achieve a sustained therapeutic goal may help to decrease costs for national health services and reduce the risk of serious infection. However, there is little information about whether such a decision can be applied universally. Therefore, the objective of this study was to develop appropriateness criteria for reducing the dose of BT in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and peripheral spondyloarthritis (pSpA).Methods: The RAND/UCLA appropriateness method was coordinated by experts in the methodology. Five rheumatologists with clinical research experience in RA and/or SpA selected and precisely defined the variables considered relevant when deciding to reduce the dose of BT in the 3 diseases, in order to define patient profiles. Ten rheumatologists with experience in prescribing BT anonymously rated each profile on a scale of 1 (completely inappropriate) to 9 (completely appropriate) after revising a summary of the evidence obtained from 4 systematic literature reviews carried out specifically for this project.Findings: A total of 2,304 different profiles were obtained for RA, 768 for axSpA, and 3,072 for pSpA. Only 327 (14.2%) patient profiles in RA, 80 (10.4%) in axSpA, and 154 (5%) in pSpA were considered appropriate for reducing the dose of BT. By contrast, 749 (32.5%) patient profiles in RA, 270 (35.3%) in axSpA, and 1,243 (40.5%) in pSpA were considered inappropriate. The remaining profiles were considered uncertain.Interpretation: Appropriateness criteria for reducing the dose of BT were developed in 3 inflammatory conditions. These criteria can help clinicians treating these disorders to optimize the BT dose. However, further research is needed, since more than 50% of the profiles were considered uncertain and the real prevalence of each profile in daily clinical practice remains unknown.
PB Elsevier sci ltd
SN 2405-8440
YR 2017
FD 2017-11-01
LK http://hdl.handle.net/10668/18793
UL http://hdl.handle.net/10668/18793
LA en
DS RISalud
RD Apr 6, 2025