Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis: 2025 Update Part I

BACKGROUND: Rheumatoid arthritis (RA) is a severe, systemic chronic rheumatic disease, and it is important for each country and/or region to develop management recommendations adapted to its needs and resources. OBJECTIVES: To update the Argentine treatment recommendations for the management of patients with RA. METHODS: The working group comprised a principal investigator, 8 methodologists and 23 expert rheumatologists. Seventy-one PICO questions were developed. A systematic literature review (SLR) was conducted using the Medline (PubMed), LILACS, and Cochrane Library databases. Grey literature was also searched. The evidence was appraised using the GRADE methodology. Voting was anonymous and conducted virtually, and recommendations required at least 70% agreement to achieve consensus. RESULTS: A total of 21 recommendations were developed, addressing Mediterranean diet, subcutaneous versus oral methotrexate, and therapeutic strategies across different clinical scenarios, including: csDMARD naive, inadequate response (IR) to csDMARD, IR to b/tsDMARD (cycling versus swapping), monotherapy, tapering in patients with sustained remission, and management of patients with concomitant interstitial lung disease or rheumatoid vasculitis. In most cases, the levels of evidence and degrees of agreement were moderate. CONCLUSIONS: These recommendations are intended to be a practical tool to assist rheumatologists in making the most appropriate treatment decisions for their patients.

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Publication Details

Journal
JCR Journal of Clinical Rheumatology
Published
2026-07-27
DOI
https://doi.org/10.1097/rhu.0000000000002391
Primary Topic
Rheumatoid Arthritis Research and Therapies
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article
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article

Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis: 2025 Update Part I

Eduardo Mysler, Tomás Cazenave, Cecilia Asnal, Rodolfo S. Pérez Alamino et al.
JCR Journal of Clinical Rheumatology
Rheumatoid Arthritis Research and Therapies
article

Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis: 2025 Update Part I

Eduardo Mysler, Tomás Cazenave, Cecilia Asnal, Rodolfo S. Pérez Alamino, Anastasia Secco, Emilce Edith Schneeberger, Hernán Maldonado Ficco, Gustavo Citera, C Gobbi, Natalia V. Zamora, Alejandro Martínez Muñoz, Edson J. Velozo, Gustavo Casado, M. C. Vega, María Á Correa, Javier E. Rosa, Rodrigo N. García Salinas, Darío Scublinsky, José L. Velasco Zamora, Guillermo A. Berbotto, Alejandra M. Babini, Bernardo Pons-Estel, María V. Martire, Silvia B. Papasidero, Enrique R. Soriano Guppy
article en

Abstract

BACKGROUND: Rheumatoid arthritis (RA) is a severe, systemic chronic rheumatic disease, and it is important for each country and/or region to develop management recommendations adapted to its needs and resources. OBJECTIVES: To update the Argentine treatment recommendations for the management of patients with RA. METHODS: The working group comprised a principal investigator, 8 methodologists and 23 expert rheumatologists. Seventy-one PICO questions were developed. A systematic literature review (SLR) was conducted using the Medline (PubMed), LILACS, and Cochrane Library databases. Grey literature was also searched. The evidence was appraised using the GRADE methodology. Voting was anonymous and conducted virtually, and recommendations required at least 70% agreement to achieve consensus. RESULTS: A total of 21 recommendations were developed, addressing Mediterranean diet, subcutaneous versus oral methotrexate, and therapeutic strategies across different clinical scenarios, including: csDMARD naive, inadequate response (IR) to csDMARD, IR to b/tsDMARD (cycling versus swapping), monotherapy, tapering in patients with sustained remission, and management of patients with concomitant interstitial lung disease or rheumatoid vasculitis. In most cases, the levels of evidence and degrees of agreement were moderate. CONCLUSIONS: These recommendations are intended to be a practical tool to assist rheumatologists in making the most appropriate treatment decisions for their patients.

JCR Journal of Clinical Rheumatology
National University of Tucumán (AR), National University of Quilmes (AR), Universidad Nacional de Río Cuarto (AR), Universidad Nacional de Córdoba (AR), Universidad Autónoma de la Ciudad de México (MX), Pertamina (Indonesia) (ID), Universidad de Buenos Aires (AR), Argerich Hospital (AR), Hospital Italiano de Buenos Aires (AR), Transnet (South Africa) (ZA), El Hospital General de Agudos Carlos G. Durand (AR), Universidad Adventista del Plata (AR), Bernardino Rivadavia Natural Sciences Museum (AR), Hospital Fernández (AR), Little Company of Mary Hospital (US), Instituto Nacional de Rehabilitación Psicofísica (AR), Hospital Militar Central (CO), Hospital Provincial de Rosario (AR), Hospital Italiano La Plata (AR), Servicio Diabetología Hospital Córdoba (AR), Argentine Water and Sanitation (Argentina) (AR), Hospital Alemán (AR), Center for Rheumatology (US), Universidad Nacional de La Plata (AR)
Partnerships for the goals
Openalex Percentile: Top 8%
Rheumatoid Arthritis Research and Therapies
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