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Title: New ACR Guidelines Update Strategies for Treating RA
URL: http://www.pslgroup.com/dg/2262FE.htm
Doctor's Guide
July 22, 2008


BIRMINGHAM, Ala -- July 22, 2008 -- Proven combinations of medicines and the introduction of new antiarthritis drugs have significantly improved the treatment of rheumatoid arthritis (RA), according to guidelines issued by the American College of Rheumatology (ACR).

Lead author Kenneth Saag, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, said the new guidelines update strategies for treating RA with the goal of preventing joint damage and disability.

The new recommendations do not strive to replace individualised medical decisions, Dr. Saag said. Instead, they are meant to guide rheumatologists and other healthcare workers toward the most updated recommendations. The last ACR guidelines for RA treatment were published in 2002.

"The recommendations developed are not intended to be used in a 'cookbook' or prescriptive manner or to limit a physician's clinical judgement," Dr. Saag said. "They provide guidance based on clinical evidence and expert panel input."

The recommendations focus on disease-modifying antirheumatic drugs (DMARDs) and anti-TNF agents. Some of the key recommendations include:

· Methotrexate or leflunomide therapy is recommended for most RA patients.
· Anti-TNF agents etanercept, infliximab, or adalimumab along with methotrexate can be used in new or early RA cases with worsening and severe symptoms.
· Doctors should not initiate or resume treatment with methotrexate, leflunomide, or biologics if RA patients have active bacterial infection, shingles (herpes zoster), hepatitis B, hepatitis C, and active or latent tuberculosis.
· Doctors should not prescribe anti-TNF agents to patients with a history of heart failure, lymphoma, or multiple sclerosis.

SOURCE: University of Alabama at Birmingham

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