[Italian consensus on the recommendations about the use of methotrexate for the treatment of rheumatic diseases with a focus on rheumatoid arthritis: results from the "3E initiative"].
OBJECTIVE
To develop a set of national evidence-based recommendations for the use of Methotrexate (MTX) in daily clinical practice.


METHODS
A panel of 37 Italian Rheumatologists reviewed 10 international recommendations formulated during the "3E (Evidence, Expertise, Exchange) initiative" for the year 2007-8, following a systematic literature search in Medline, Embase, Cochrane Library, and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts and the revision of selected papers and the appraisal of Oxford levels of evidence. Moreover, the same panel by the same methodology formulated further 5 recommendations on topics previously selected by Italian representatives to 3E initiative. The agreement about the set of proposed recommendations was stated by a consensus process and the potential impact on clinical practice was assessed.


RESULTS
International Recommendations were analysed and changed when appropriate. In addition, 5 national recommendations were developed by identifying 6371 references, selecting and evaluating the 29 ones satisfying Evidence Based Medicine principles.


CONCLUSIONS
A set of 15 national recommendations for the use of MTX in daily clinical practice was developed. These recommendations are evidence-based and integrate the expertise of a large panel of Italian rheumatologists.
De Leonardis
F
F
Unità di Reumatologia, Policlinico, Napoli, Italia.
Alivernini
S
S
Bonacci
E
E
Buono
A M
AM
Bombardieri
S
S
Ferraccioli
G F
GF
Montecucco
C
C
Sinigaglia
L
L
Trotta
F
F
Valentini
G
G
D006801:Humans; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D018849:Controlled Clinical Trials as Topic; D003697:Delphi Technique; D007558:Italy; D015201:Meta-Analysis as Topic; D008727:Methotrexate / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy
D018501:Antirheumatic Agents; D008727:Methotrexate