Uso de terapias biológicas no tratamento da artrite reumatoide: comparação entre as principais recomendações mundiais e a brasileira

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic systemic and progressive infl ammatory disorder of the joints, which can result in deformity and functional disability. The diagnosis, treatment, and follow-up of patients with RA vary worldwide. The major societies of rheumatology, as well as governmental agencies in most countries, have tried to establish recommendations addressing diagnosis, treatment, and follow-up of RA. Despite the rapid advance in discovering new drugs, with increasingly effi cient therapeutic responses, these recommendations have not been updated accordingly. Thus, efforts should be focused on standardizing the procedures established. Objective: Compare the main international recommendations for treatment of RA with the Brazilian protocols of the Brazilian Society of Rheumatology and Ministry of Health. Methods: The protocols of the following entities for treating RA were assessed: Brazilian Ministry of Health, Brazilian Society of Rheumatology, PANLAR/GLADAR, American College of Rheumatology, European League Against Rheumatism (EULAR), and Mexican College of Rheumatology. Results: Signifi cant differences were identifi ed between the several recommendations, especially regarding the criteria for beginning biological therapies, hierarchic sequence for using available biological drugs, and for suspending or switching them. Conclusions: The recommendations for treatment of RA should be more frequently updated. The worldwide standardization of criteria for elaborating recommendations would be of great value to provide similar guidance to rheumatologists in countries and regions throughout the world.