title: Investigation on Brazilian clinical practices in rheumatoid arthritis: the Brazilian rheumatoid arthritis clinical practices investigation--BRACTICE.
abstract: Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease causing significant social, medical, and economic impact. Several therapeutic regimens are available within the medical arsenal. The rational and reasoned use of various medications approved for their treatment is imperative. This study aimed to evaluate how Brazilian rheumatologists use the drugs available to combat the disease.For this, 128 Brazilian rheumatologists from public and private health services responded to an 18-item questionnaire, sent over the Internet, about different situations of drug treatment of RA. The answers helped to confirm the trends among Brazilian rheumatologists in the drug treatment of RA.The study results have shown that most Brazilian rheumatologists follow the guidelines and consensus established by the Brazilian Society of Rheumatology for the treatment of RA. A small proportion, however, start the biologic therapy in early stages of the disease, including the very early stage, as the first treatment option. Most experts use corticosteroids in low doses early in the treatment.
  
  
  CONCLUSIONS
  This study confirms that the majority but not all Brazilian rheumatologists follow, in their daily practice, established guidelines and consensus for the treatment of RA. However, it also shows that some few rheumatologists start with anti-tumor necrosis factor therapy in very early arthritis independently of disease severity or prognostic factors.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo. m.helfen@terra.com.br
authors.forename: Milton
authors.initials: M
authors.lastname: Helfenstein
authors.forename: Ari Stiel Radu
authors.initials: AS
authors.lastname: Halpern
authors.forename: Manoel Barros
authors.initials: MB
authors.lastname: Bertolo
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001938:Brazil; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012219:Rheumatology / Q000639:trends*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents