Structured Abstract

Contents

• Preface
• Acknowledgements
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Causes and Diagnosis
  • Treatment of Rheumatoid Arthritis
  • Treatment Strategies
  • Scope and Key Questions
  • Organization of the Report
• Methods
  • Topic Development
  • Literature Search
  • Study Selection
  • Data Extraction
  • Quality Assessment
  • Applicability Assessment
  • Grading Strength of Evidence
  • Data Synthesis
  • Peer Review
• Results
  • Introduction
  • Key Question 1 Reductions in Disease Activity, Limitations of Disease Progression, and Maintenance of Remission
  • Key Question 2 Functional Capacity and Quality of Life
  • Key Question 3 Harms, Tolerability, Adverse Effects, or Adherence
  • Key Question 4 Benefits and Harms for Selected Populations
• Discussion
  • Key Findings
  • Applicability
  • Conclusions
  • Clinical Relevance
  • Future Research
• References
• Appendix A Search Strings
• Appendix B Review and Abstraction Forms
• Appendix C Articles by Database Searched
• Appendix D Excluded Studies
• Appendix E Evidence Tables
• Appendix F Criteria for Assessing the Quality of Individual Studies
• Appendix G Clinical and Self-Reported Scales and Instruments Commonly Used in Studies of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis
• Appendix H Excluded Studies: Characteristics of Studies With Poor Internal Validity
• Appendix I Strength of Evidence Tables
• Appendix J Mixed Treatment Comparisons Results: ACR 20 and ACR 70
• Appendix K Mixed Treatment Comparisons Sensitivity Analysis Methods

Updated June 2012. Errata: Tables 2, 3, and 4 have been corrected.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10056-I, Prepared by: RTI International–University of North Carolina Evidence-based Practice Center, Research Triangle Park, NC

Suggested citation:

Donahue KE, Jonas DE, Hansen RA, Roubey R, Jonas B, Lux LJ, Gartlehner G, Harden E, Wilkins T, Peravali V, Bangdiwala SI, Yuen A, Thieda P, Morgan LC, Crotty K, Desai R, Van Noord M. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55. (Prepared by RTI-UNC Evidence-based Practice Center under Contract No. 290-02-0016-I.) Rockville, MD: Agency for Healthcare Research and Quality. April 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the RTI International–University of North Carolina (RTI–UNC) Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10056-I). The findings and conclusions in this document are those of the author(s), who are responsible for its content; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help healthcare decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators has any affiliations for financial involvement that conflicts with the material presented in this report.

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