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Comparative Study
. 2013 Feb;72(1):6-9.
doi: 10.1007/s00393-012-1093-6.

The new 2012 German recommendations for treating rheumatoid arthritis : differences compared to the European standpoint

J Wollenhaupt  1 , K Albrecht, K Krüger, U Müller-Ladner
Affiliations
Comparative Study

The new 2012 German recommendations for treating rheumatoid arthritis : differences compared to the European standpoint

J Wollenhaupt et al. Z Rheumatol. 2013 Feb.

Abstract
in English, German

The German Society for Rheumatology recently published guidelines for the sequential therapy of rheumatoid arthritis (RA). These recommendations were developed as a transition from the 2010 EULAR (EUropean League Against Rheumatism) recommendations to the national clinical practice and are based on an updated systematic literature research and expert discussion. While most EULAR recommendations have remained unchanged, some were modified based on new evidence from randomized, controlled trials, current clinical practice, or national drug approval status. The guidelines also include a treatment algorithm for sequential therapy of RA with disease-modifying agents including biologics.

Die Deutsche Gesellschaft für Rheumatologie (DGRh) hat jüngst eine S1-Leitlinie zur sequenziellen medikamentösen Therapie der rheumatoiden Arthritis veröffentlicht. Die Empfehlungen beruhen auf einer Bewertung der EULAR (EUropean League Against Rheumatism) Recommendations vor dem Hintergrund der landesüblichen klinischen Praxis auf der Basis einer aktualisierten systematischen Literaturrecherche und eines Expertenurteils. Während sich viele EULAR-Empfehlungen in der deutschen Version unverändert finden, ergaben sich für einige Änderungen auf der Grundlage neuer Evidenz aus randomisierten kontrollierten Studien, derzeitiger klinischer Praxis oder des nationalen Medikamentenzulassungsstatus. Konkretisiert werden die Empfehlungen durch einen überarbeiteten Therapiealgorithmus mit Basistherapeutika einschließlich Biologika. Der vorliegende Kommentar soll – auch für englischsprachige Leser – die Gemeinsamkeiten und Unterschiede der deutschen Empfehlungen 2012 und der EULAR Recommendations von 2010 erläutern.

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Figures

Fig. 1
Fig. 1
Algorithm based on the German 2012 recommendations for the medical treatment of rheumatoid arthritis. ABC abatacept, ADM adalimumab, CEZ certolizumab, ETC etanercept, GOM golimumab, INX infliximab, RIX rituximab, TOZ tocilizumab, GC glucocorticoids, CiA ciclosporin A, HCQ hydroxychloroquine, LEF leflunomide, MTX methotrexate, SSZ sulfasalazine, TNF TNF inhibitors. *high disease activity, especially in combination with poor prognostic factors, **in case of MTX contraindication, ADM, CTZ, ETC are also approved in monotherapy, ***in case of MTX contraindication, TOZ is also approved in monotherapy and has demonstrated similar efficacy in monotherapy as well as in combination with MTX
See this image and copyright information in PMC

References

    1. Krüger Z Rheumatol. 2012;71:592. doi: 10.1007/s00393-012-1038-0. - DOI - PubMed
    1. Smolen Ann Rheum Dis. 2010;69:964. doi: 10.1136/ard.2009.126532. - DOI - PMC - PubMed
    1. Albrecht Z Rheumatol. 2012;71:604. doi: 10.1007/s00393-012-1048-y. - DOI - PubMed
    1. Wollenhaupt Akt Rheumatol. 2009;34:234. doi: 10.1055/s-0029-1220906. - DOI

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