Recommendations of the Argentine Society of Rheumatology for the Treatment of Patients With Rheumatoid Arthritis. Update 2025 Part II. Definitions in the Context of RA Treatment and Therapeutic Strategies for Special Situations and Comorbidities
Background: In the context of treatment recommendations for rheumatoid arthritis (RA), it is important to establish definitions related to treatment adjusted in specific situations and in the presence of comorbidities. Objectives: To develop recommendations based on the best evidence regarding to the treatment of patients with RA in special situations, healthy habits, and the presence of comorbidities. Methods: A systematic literature review was conducted in PubMed, LILACS, and the Cochrane Library until April 30, 2023. Two independent methodologists selected studies. Draft statements were developed and voted on, with ≥70% agreement required for inclusion. Results: Fifty-four statements were formulated. Key recommendations include: against treatment in asymptomatic high-risk individuals without clinical arthritis (preclinical RA); the use of methotrexate in seropositive patients with imaging-detected subclinical arthritis; definitions for early RA, window of opportunity, difficult-to-treat RA, and sustained remission; guidance on DMARD during pregnancy and breastfeeding; preference for non-TNF biologics in obese patients; caution with TNFi in stage III to IV congestive heart failure; antiviral prophylaxis in chronic hepatitis B; and structured recommendations on oral hygiene and smoking cessation. Conclusions: These statements complement general RA treatment recommendations and support better patient management, based on scientific evidence and adapted to the characteristics, resources, and opportunities of our country.
Authors
- Tomás Cazenave
- María Celina De la Vega (ORCID: https://orcid.org/0000-0003-1171-3519)
- Anastasia Secco (ORCID: https://orcid.org/0000-0002-9381-3902)
- Guillermo Berbotto (ORCID: https://orcid.org/0000-0003-0264-6182)
- Carla Sol Maldini
- Carla Andrea Gobbi (ORCID: https://orcid.org/0000-0002-9750-4939)
- Enrique Roberto Soriano Guppy
- Emilce Edith Schneeberger (ORCID: https://orcid.org/0000-0001-7671-5748)
- Victoria Martiré
- Silvia Beatriz Papasidero (ORCID: https://orcid.org/0000-0001-5438-2962)
- José Luis Velasco Zamora (ORCID: https://orcid.org/0000-0001-8386-8937)
- Edson Javier Velozo (ORCID: https://orcid.org/0000-0002-7651-7116)
- Bernardo Antonio Pons‐Estel (ORCID: https://orcid.org/0000-0003-2518-0266)
- Alejandra Magdalena Babini (ORCID: https://orcid.org/0000-0002-0141-1624)
- Hernán Maldonado Ficco (ORCID: https://orcid.org/0000-0002-7027-1768)
- María de los Ángeles Correa (ORCID: https://orcid.org/0000-0002-8885-390X)
- Gustavo Citera (ORCID: https://orcid.org/0000-0002-3724-1874)
- Alejandro Martínez Muñoz
- Gustavo Christian Casado
- Rodrigo Nicolás Garcia Salinas
- Darío Scublinsky
- Javier Eduardo Rosa
- Rodolfo Sebastián Pérez Alamino
- Eduardo Fabián Mysler
- Cecilia Adma Asnal
Institutions
- National University of Tucumán (AR)
- National University of Quilmes (AR)
- Universidad Nacional de Río Cuarto (AR)
- Universidad Nacional de Córdoba (AR)
- Universidad de Buenos Aires (AR)
- Argerich Hospital (AR)
- Hospital Italiano de Buenos Aires (AR)
- Transnet (South Africa) (ZA)
- 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)
- Hospital Alemán (AR)
- Hospital Central Militar (MX)
- Universidad Nacional de La Plata (AR)
Publication Details
- Journal
- JCR Journal of Clinical Rheumatology
- Published
- 2026-09-21
- DOI
- https://doi.org/10.1097/rhu.0000000000002388
- Primary Topic
- Rheumatoid Arthritis Research and Therapies
- Type
- article
- Field-Weighted Citation Impact
- 0.00