title: Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.
abstract: The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).
authors.forename: João Eurico
authors.initials: JE
authors.lastname: Fonseca
authors.forename: Helena
authors.initials: H
authors.lastname: Canhão
authors.forename: Paulo
authors.initials: P
authors.lastname: Reis
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Santos
authors.forename: Jaime
authors.initials: J
authors.lastname: Branco
authors.forename: Alberto
authors.initials: A
authors.lastname: Quintal
authors.forename: Armando
authors.initials: A
authors.lastname: Malcata
authors.forename: Domingos
authors.initials: D
authors.lastname: Araújo
authors.forename: Francisco
authors.initials: F
authors.lastname: Ventura
authors.forename: Guilherme
authors.initials: G
authors.lastname: Figueiredo
authors.forename: José Canas
authors.initials: JC
authors.lastname: da Silva
authors.forename: José Vaz
authors.initials: JV
authors.lastname: Patto
authors.forename: Mário Viana
authors.initials: MV
authors.lastname: de Queiroz
authors.forename: Rui André
authors.initials: RA
authors.lastname: Santos
authors.forename: Adriano José
authors.initials: AJ
authors.lastname: Neto
authors.forename: Alves de
authors.initials: Ad
authors.lastname: de Matos
authors.forename: Ana
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Ana Filipa
authors.initials: AF
authors.lastname: Mourão
authors.forename: Ana Sofia
authors.initials: AS
authors.lastname: Ribeiro
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Cravo
authors.forename: Anabela
authors.initials: A
authors.lastname: Barcelos
authors.forename: Anabela
authors.initials: A
authors.lastname: Cardoso
authors.forename: António
authors.initials: A
authors.lastname: Vilar
authors.forename: Arecili
authors.initials: A
authors.lastname: Braña
authors.forename: Augusto
authors.initials: A
authors.lastname: Faustino
authors.forename: Candida
authors.initials: C
authors.lastname: Silva
authors.forename: Fátima
authors.initials: F
authors.lastname: Godinho
authors.forename: Inês
authors.initials: I
authors.lastname: Cunha
authors.forename: José António
authors.initials: JA
authors.lastname: Costa
authors.forename: José António Melo
authors.initials: JA
authors.lastname: Gomes
authors.forename: José António Araújo
authors.initials: JA
authors.lastname: Pinto
authors.forename: J A Pereira
authors.initials: JA
authors.lastname: da Silva
authors.forename: Luís Cunha
authors.initials: LC
authors.lastname: Miranda
authors.forename: Luís
authors.initials: L
authors.lastname: Inês
authors.forename: Luís Maurício
authors.initials: LM
authors.lastname: Santos
authors.forename: Margarida
authors.initials: M
authors.lastname: Cruz
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Salvador
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Ferreira
authors.forename: Maria
authors.initials: M
authors.lastname: Rial
authors.forename: Miguel
authors.initials: M
authors.lastname: Bernardes
authors.forename: Mónica
authors.initials: M
authors.lastname: Bogas
authors.forename: Paula
authors.initials: P
authors.lastname: Araújo
authors.forename: Pedro
authors.initials: P
authors.lastname: Machado
authors.forename: Patrícia
authors.initials: P
authors.lastname: Pinto
authors.forename: Rui Gomes
authors.initials: RG
authors.lastname: de Melo
authors.forename: Sara
authors.initials: S
authors.lastname: Cortes
authors.forename: Sérgio
authors.initials: S
authors.lastname: Alcino
authors.forename: Susana
authors.initials: S
authors.lastname: Capela
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001691:Biological Therapy; D006801:Humans