Evidence‐based recommendations for the diagnosis and management of rheumatoid arthritis for non‐rheumatologists: Integrating systematic literature research and expert opinion of the Thai Rheumatism Association

Abstract

These evidence-based recommendations provide practical guidance for diagnosis, fundamental management and referral of patients with RA for non-rheumatologists. However, it should be incorporated with clinical judgments and decisions about care for each individual patient.

Rheumatoid arthritis management in the APLAR region: Perspectives from an expert panel of rheumatologists, patients and community oriented program for control of rheumatic diseases

“…To address the shortage of rheumatologists in some countries, healthcare providers have found creative solutions, such as the training of non‐rheumatologists to help with diagnosis and parts of routine follow up. In Thailand, the Thai Rheumatism Association developed evidence‐based recommendations on RA diagnosis and management for non‐rheumatologists, 20 and local medical societies in India and Pakistan are working with associations such as APLAR and COPCORD to develop and implement formal training courses for non‐rheumatologists. For example, in Pakistan, a tertiary‐care rheumatology center developed a 9‐month course for family physicians using a blended learning technique, which was partly funded by a grant from ILAR.…”

2016 updated Thai Rheumatism Association Recommendations for the use of biologic and targeted synthetic disease‐modifying anti‐rheumatic drugs in patients with rheumatoid arthritis

“…Rationale and recommendations for the use of csDMARDs in Thai RA patients have been recently published. The committee recommended that csDMARDs should be initiated when the diagnosis of RA is established …”

“…), unless the patient has adverse events or intolerance to the drugs, regardless of poor prognostic factors. MTX should be first line csDMARDs . Whether the patients should receive low dose GCs before starting bDMARDs or tsDMARD is left to the discretion of the physician.…”

“…Many rheumatology organizations, including the TRA, recommend routine laboratory tests (including complete blood count, renal and liver function, and chest radiograph), as well as screening for HBV, HCV and HIV infections (in patients at risk), and active and latent tuberculosis in all RA patients before starting csDMARDs, bDMARDs or tsDMARD in order to ensure their safety . The type of investigation depends on availability of the test in each institution.…”

Label‐free Electrochemical Immunosensor for Sensitive Detection of Rheumatoid Arthritis Biomarker Anti‐CCP‐ab

“…Rheumatoid arthritis (RA) is a kind of chronic systemic inflammatory disease characterized by synovitis, which usually causes permanent damage to joints, arthritis malformation, and joint dysfunction. In severe cases, it even implicates other organs throughout the body, resulting in the worse quality of patients' life and shorter life expectancies [1,2]. Besides, studies have shown that patients with RA have a higher risk of suffering from cardiovascular disease and depression than normal people [3,4].…”