Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR

Yıl: 2015 Cilt: 30 Sayı: 4 Sayfa Aralığı: 271 - 284 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR

Öz:
Objectives: This study aims to report Turkish League Against Rheumatism s assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of InterestThe authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial DisclosureThe authors received no financial support for the research and/or authorship of this article.
Anahtar Kelime:

Konular: Romatoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for treatment of rheumatoid arthritis. Lancet 2007;370:1861-74.
  • 2. Smolen JS, van der Heijde D, Machold KP, Aletaha D, Landewé R. Proposal for a new nomenclature of disease-modifying antirheumatic drugs. Ann Rheum Dis 2014;73:3-5.
  • 3. Ataman , Borman P, Evcik D, Aydo¤ E, Ayhan F, Yıldızlar D, et al. Management of rheumatoid arthritis: consensus recommendations from the Turkish League Against Rheumatism. Turk J Rheumatol 2011;26:273-94.
  • 4. Smolen JS, Landewé R, Breedveld FC, Buch M, Burmester G, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease- modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014;73:492-509.
  • 5. Balsa A, de Miguel E, Castillo C, Peiteado D, Martín- Mola E. Superiority of SDAI over DAS-28 in assessment of remission in rheumatoid arthritis patients using power Doppler ultrasonography as a gold standard. Rheumatology (Oxford) 2010;49:683-90.
  • 6. Aletaha D, Smolen J. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): a review of their usefulness and validity in rheumatoid arthritis. Clin Exp Rheumatol 2005;23:100-8.
  • 7. Bal A, Ataman , Bodur H, Rezvani A, Paker N, Tastekin N, et al. Characteristics of patients with rheumatoid arthritis in Turkey: results from the Turkish League Against Rheumatism Rheumatoid arthritis registry. Arch Rheumatol 2015;30:1-8.
  • 8. Aletaha D, Landewe R, Karonitsch T, Bathon J, Boers M, Bombardier C, et al. Reporting disease activity in clinical trials of patients with rheumatoid arthritis: EULAR/ACR collaborative recommendations. Arthritis Rheum 2008;59:1371-7.
  • 9. Smolen JS, Han C, van der Heijde DM, Emery P, Bathon JM, Keystone E, et al. Radiographic changes in rheumatoid arthritis patients attaining different disease activity states with methotrexate monotherapy and infliximab plus methotrexate: the impacts of remission and tumour necrosis factor blockade. Ann Rheum Dis 2009;68:823-7.
  • 10. Visser K, van der Heijde D. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature. Ann Rheum Dis 2009;68:1094-9.
  • 11. Gutierrez-Ureña S, Molina JF, García CO, Cuéllar ML, Espinoza LR. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum 1996;39:272-6.
  • 12. Kremer JM, Alarcón GS, Weinblatt ME, Kaymakcian MV, Macaluso M, Cannon GW, et al. Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis: a multicenter study with literature review. Arthritis Rheum 1997;40:1829-37.
  • 13. Walker AM, Funch D, Dreyer NA, Tolman KG, Kremer JM, Alarcón GS, et al. Determinants of serious liver disease among patients receiving low- dose methotrexate for rheumatoid arthritis. Arthritis Rheum 1993;36:329-35.
  • 14. Pincus T, Yazici Y, Sokka T, Aletaha D, Smolen JS. Methotrexate as the “anchor drug” for the treatment of early rheumatoid arthritis. Clin Exp Rheumatol 2003;21:179-85.
  • 15. Breedveld FC, Weisman MH, Kavanaugh AF, Cohen SB, Pavelka K, van Vollenhoven R, et al. The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum 2006;54:26-37.
  • 16. Heimans L, Wevers-de Boer KV, Visser K, Goekoop RJ, van Oosterhout M, Harbers JB, et al. A two-step treatment strategy trial in patients with early arthritis aimed at achieving remission: the IMPROVED study. Ann Rheum Dis 2014;73:1356-61.
  • 17. Klareskog L, van der Heijde D, de Jager JP, Gough A, Kalden J, Malaise M, et al. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 2004;363:675-81.
  • 18. Salliot C, van der Heijde D. Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research. Ann Rheum Dis 2009;68:1100-4.
  • 19. St Clair EW, van der Heijde DM, Smolen JS, Maini RN, Bathon JM, Emery P, et al. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum 2004;50:3432-43.
  • 20. Tak PP, Rigby WF, Rubbert-Roth A, Peterfy CG, van Vollenhoven RF, Stohl W, et al. Inhibition of joint damage and improved clinical outcomes with rituximab plus methotrexate in early active rheumatoid arthritis: the IMAGE trial. Ann Rheum Dis 2011;70:39-46.
  • 21. van Ede AE, Laan RF, Rood MJ, Huizinga TW, van de Laar MA, van Denderen CJ, et al. Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis: a forty-eight week, multicenter, randomized, double- blind, placebo-controlled study. Arthritis Rheum 2001;44:1515-24.
  • 22. Westhovens R, Robles M, Ximenes AC, Nayiager S, Wollenhaupt J, Durez P, et al. Clinical efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis and poor prognostic factors. Ann Rheum Dis 2009;68:1870-7.
  • 23. Dörner T, Isenberg D, Jayne D, Wiendl H, Zillikens D, Burmester G. Current status on B-cell depletion therapy in autoimmune diseases other than rheumatoid arthritis. Autoimmun Rev 2009;9:82-9.
  • 24. Chatzidionysiou K, Lie E, Nasonov E, Lukina G, Hetland ML, Tarp U, et al. Highest clinical effectiveness of rituximab in autoantibody-positive patients with rheumatoid arthritis and in those for whom no more than one previous TNF antagonist has failed: pooled data from 10 European registries. Ann Rheum Dis 2011;70:1575-80.
  • 25. Kekow J, Mueller-Ladner U, Schulze-Koops H. Rituximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNFa blocker failure. Biologics 2012;6:191-9.
  • 26. Mease PJ, Revicki DA, Szechinski J, Greenwald M, Kivitz A, Barile-Fabris L, et al. Improved health-related quality of life for patients with active rheumatoid arthritis receiving rituximab: Results of the Dose- Ranging Assessment: International Clinical Evaluation of Rituximab in Rheumatoid Arthritis (DANCER) Trial. J Rheumatol 2008;35:20-30.
  • 27. Keystone EC, Cohen SB, Emery P, Kremer JM, Dougados M, Loveless JE, et al. Multiple courses of rituximab produce sustained clinical and radiographic efficacy and safety in patients with rheumatoid arthritis and an inadequate response to 1 or more tumor necrosis factor inhibitors: 5-year data from the REFLEX study. J Rheumatol 2012;39:2238-46.
  • 28. Khan A, Scott D. Rituximab after methotrexate failure in rheumatoid arthritis: evaluation of the SERENE trial. Expert Opin Biol Ther 2011;11:1515-8.
  • 29. Rubbert-Roth A, Tak PP, Zerbini C, Tremblay JL, Carreño L, Armstrong G, et al. Efficacy and safety of various repeat treatment dosing regimens of rituximab in patients with active rheumatoid arthritis: results of a Phase III randomized study (MIRROR). Rheumatology (Oxford) 2010;49:1683-93.
  • 30. Emery P, Fleischmann R, Filipowicz-Sosnowska A, Schechtman J, Szczepanski L, Kavanaugh A, et al. The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double- blind, placebo-controlled, dose-ranging trial. Arthritis Rheum 2006;54:1390-400.
  • 31. Gottenberg JE, Ravaud P, Bardin T, Cacoub P, Cantagrel A, Combe B, et al. Risk factors for severe infections in patients with rheumatoid arthritis treated with rituximab in the autoimmunity and rituximab registry. Arthritis Rheum 2010;62:2625-32.
  • 32. De La Torre I, Leandro MJ, Valor L, Becerra E, Edwards JC, Cambridge G. Total serum immunoglobulin levels in patients with RA after multiple B-cell depletion cycles based on rituximab: relationship with B-cell kinetics. Rheumatology (Oxford) 2012;51:833-40.
  • 33. van Vollenhoven RF, Emery P, Bingham CO 3rd, Keystone EC, Fleischmann RM, Furst DE, et al. Long- term safety of rituximab in rheumatoid arthritis: 9.5- year follow-up of the global clinical trial programme with a focus on adverse events of interest in RA patients. Ann Rheum Dis 2013;72:1496-502.
  • 34. Westra J, van Assen S, Wilting KR, Land J, Horst G, de Haan A, et al. Rituximab impairs immunoglobulin (Ig)M and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients. Clin Exp Immunol 2014;178:40-7.
  • 35. Keyser FD. Choice of Biologic Therapy for Patients with Rheumatoid Arthritis: The Infection Perspective. Curr Rheumatol Rev 2011;7:77-87.
  • 36. Gigi E, Georgiou T, Mougiou D, Boura P, Raptopoulou- Gigi M. Hepatitis B reactivation in a patient with rheumatoid arthritis with antibodies to hepatitis B surface antigen treated with rituximab. Hippokratia 2013;17:91-3.
  • 37. Keystone E, Landewé R, van Vollenhoven R, Combe B, Strand V, Mease P, et al. Long-term safety and efficacy of certolizumab pegol in combination with methotrexate in the treatment of rheumatoid arthritis: 5-year results from the RAPID 1 trial and open-label extension. Ann Rheum Dis 2014;73:2094-100.
  • 38. Strand V, Smolen JS, van Vollenhoven RF, Mease P, Burmester GR, Hiepe F, et al. Certolizumab pegol plus methotrexate provides broad relief from the burden of rheumatoid arthritis: analysis of patient- reported outcomes from the RAPID 2 trial. Ann Rheum Dis 2011;70:996-1002.
  • 39. Fleischmann R, Vencovsky J, van Vollenhoven RF, Borenstein D, Box J, Coteur G, et al. Efficacy and safety of certolizumab pegol monotherapy every 4 weeks in patients with rheumatoid arthritis failing previous disease-modifying antirheumatic therapy: the FAST4WARD study. Ann Rheum Dis 2009;68:805-11.
  • 40. Stephens S, Brown D, Nesbitt A, Foulkes B. Lack of placental transfer and accumulation in milk of an anti-TNF PEGylated Fab’ fragment in rats. J Crohn’s Colitis 2007;1:43.
  • 41. Mahadevan U, Abreu MT. Certolizumab use in pregnancy: low levels detected in cord blood. Gastroenterology 2009;136:146.
  • 42. Yoo DH, Hrycaj P, Miranda P, Ramiterre E, Piotrowski M, Shevchuk S, et al. A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Ann Rheum Dis 2013;72:1613-20.
  • 43. Park W, Hrycaj P, Jeka S, Kovalenko V, Lysenko G, Miranda P, et al. A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study. Ann Rheum Dis 2013;72:1605-12.
  • 44. Burmester GR, Rigby W, Van Vollenhoven RF, Kay J, Rubbert-Roth A, Kelman A, et al. Tocilizumab in combination therapy and monotherapy versus methotrexate in methotrexate-naive patients with early rheumatoid arthritis: clinical and radiographic outcomes from a randomized, placebo-controlled trial. Arthritis Rheum 2013;65:2767.
  • 45. Krieckaert CL, Nurmohamed MT, Wolbink GJ. Methotrexate reduces immunogenicity in adalimumab treated rheumatoid arthritis patients in a dose dependent manner. Ann Rheum Dis 2012;71:1914-5.
  • 46. Heiberg MS, Koldingsnes W, Mikkelsen K, Rødevand E, Kaufmann C, Mowinckel P, et al. The comparative one-year performance of anti-tumor necrosis factor alpha drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: results from a longitudinal, observational, multicenter study. Arthritis Rheum 2008;59:234-40.
  • 47. Soliman MM, Ashcroft DM, Watson KD, Lunt M, Symmons DP, Hyrich KL. Impact of concomitant use of DMARDs on the persistence with anti-TNF therapies in patients with rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register. Ann Rheum Dis 2011;70:583-9.
  • 48. Listing J, Strangfeld A, Rau R, Kekow J, Gromnica- Ihle E, Klopsch T, et al. Clinical and functional remission: even though biologics are superior to conventional DMARDs overall success rates remain low--results from RABBIT, the German biologics register. Arthritis Res Ther 2006;8:66.
  • 49. Askling J, Fored CM, Brandt L, Baecklund E, Bertilsson L, Feltelius N, et al. Time-dependent increase in risk of hospitalisation with infection among Swedish RA patients treated with TNF antagonists. Ann Rheum Dis 2007;66:1339-44.
  • 50. Mariette X, Gottenberg JE, Ravaud P, Combe B. Registries in rheumatoid arthritis and autoimmune diseases: data from the French registries. Rheumatology (Oxford) 2011;50:222-9.
  • 51. Yazici Y, Shi N, John A. Utilization of biologic agents in rheumatoid arthritis in the United States: analysis of prescribing patterns in 16,752 newly diagnosed patients and patients new to biologic therapy. Bull NYU Hosp Jt Dis 2008;66:77-85.
  • 52. Lee SJ, Chang H, Yazici Y, Greenberg JD, Kremer JM, Kavanaugh A. Utilization trends of tumor necrosis factor inhibitors among patients with rheumatoid arthritis in a United States observational cohort study. J Rheumatol 2009;36:1611-7.
  • 53. Sarzi-Puttini P, Antivalle M, Marchesoni A, Favalli EG, Gorla R, Filippini M, et al. Efficacy and safety of anti-TNF agents in the Lombardy rheumatoid arthritis network (LORHEN). Reumatismo 2008;60:290-5.
  • 54. Jones G, Sebba A, Gu J, Lowenstein MB, Calvo A, Gomez-Reino JJ, et al. Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: the AMBITION study. Ann Rheum Dis 2010;69:88-96.
  • 55. Nishimoto N, Hashimoto J, Miyasaka N, Yamamoto K, Kawai S, Takeuchi T, et al. Study of active controlled monotherapy used for rheumatoid arthritis, an IL-6 inhibitor (SAMURAI): evidence of clinical and radiographic benefit from an x ray reader- blinded randomised controlled trial of tocilizumab. Ann Rheum Dis 2007;66:1162-7.
  • 56. Gabay C, Emery P, van Vollenhoven R, Dikranian A, Alten R, Pavelka K, et al. Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial. Lancet 2013;381:1541-50.
  • 57. Huizinga TW, Conaghan PG, Martin-Mola E, Schett G, Amital H, Xavier RM, et al. Clinical and radiographic outcomes at 2 years and the effect of tocilizumab discontinuation following sustained remission in the second and third year of the ACT-RAY study. Ann Rheum Dis 2015;74:35-43.
  • 58. Smolen J, Gomez-Reino JJ, Vernon E, Rubbert- Roth A, Emery P. Efficacy of Tocilizumab in patients with RA and inadequate response to DMARDs or TNF inhibitors: Up to 3.5-year data from ongoing extension studies. Ann Rheum Dis 2010;69:542.
  • 59. Dougados M, Kissel K, Sheeran T, Tak PP, Conaghan PG, Mola EM, et al. Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis 2013;72:43-50.
  • 60. Emery P, Kvien TK, Combe B, Freundlich B, Robertson D, Ferdousi T, et al. Combination etanercept and methotrexate provides better disease control in very early (_____=4 months) versus early rheumatoid arthritis (>4 months and _____2 years): post hoc analyses from the COMET study. Ann Rheum Dis 2012;71:989-92.
  • 61. van Riel PL, Taggart AJ, Sany J, Gaubitz M, Nab HW, Pedersen R, et al. Efficacy and safety of combination etanercept and methotrexate versus etanercept alone in patients with rheumatoid arthritis with an inadequate response to methotrexate: the ADORE study. Ann Rheum Dis 2006;65:1478-83.
  • 62. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum 2005;52:3381-90.
  • 63. Kavanaugh A, Fleischmann RM, Emery P, Kupper H, Redden L, Guerette B, et al. Clinical, functional and radiographic consequences of achieving stable low disease activity and remission with adalimumab plus methotrexate or methotrexate alone in early rheumatoid arthritis: 26-week results from the randomised, controlled OPTIMA study. Ann Rheum Dis 2013;72:64-71.
  • 64. Detert J, Bastian H, Listing J, Weiß A, Wassenberg S, Liebhaber A, et al. Induction therapy with adalimumab plus methotrexate for 24 weeks followed by methotrexate monotherapy up to week 48 versus methotrexate therapy alone for DMARD- naive patients with early rheumatoid arthritis: HIT HARD, an investigator-initiated study. Ann Rheum Dis 2013;72:844-50.
  • 65. Kádár G, Balázs E, Soós B, Laduver A, Keszthelyi P, Szekanecz Z, et al. Disease activity after the discontinuation of biological therapy in inflammatory rheumatic diseases. Clin Rheumatol 2014;33:329-33.
  • 66. van der Kooij SM, le Cessie S, Goekoop-Ruiterman YP, de Vries-Bouwstra JK, van Zeben D, Kerstens PJ, et al. Clinical and radiological efficacy of initial vs delayed treatment with infliximab plus methotrexate in patients with early rheumatoid arthritis. Ann Rheum Dis 2009;68:1153-8.
  • 67. Emery P, Hammoudeh M, Fitzgerald O, Combe B, Martin Mola E, Bukowski J, et al. Assessing maintenance of remission with reduced dose etanercept plus methotrexate, methotrexate alone, or placebo in patients with early rheumatoid arthritis who achieved remission with etanercept and methotrextate: the PRIZE study. Ann Rheum Dis 2013;72:399.
  • 68. Smolen JS, Nash P, Durez P, Hall S, Ilivanova E, Irazoque-Palazuelos F, et al. Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet 2013;381:918-29.
  • 69. Fautrel B, Gandjbakhch F, Foltz V, Pham T, Morel J, Alfaiate T, et al. Targeting the lowest efficacious dose for rheumatoid arthritis patients in remission: clinical and structural impact of a stepdown strategy trial based on progressive spacing of TNF- blocker injections (STRASS trial). Ann Rheum Dis 2013;72:72.
  • 70. Ostergaard M, Leirisalo-Repo M, Uhlig T, Jansson M, Larsson E, Brock F, et al. In rheumatoid arthritis patients with stable low disaese activity on methotrexate plus etanercept, continuation of etanercept is superior both clinically and radiographically to discontinuation: results from a randomized, 3-armed, double-blind clinical trial. Arthritis Rheum. 2013;66:1017.
  • 71. Emery P, Burmester GR, Bykerk VP, Combe BG, Furst DE, Barré E, et al. Evaluating drug-free remission with abatacept in early rheumatoid arthritis: results from the phase 3b, multicentre, randomised, active-controlled AVERT study of 24 months, with a 12-month, double-blind treatment period. Ann Rheum Dis 2015;74:19-26.
  • 72. Aguilar-Lozano L, Castillo-Ortiz JD, Vargas-Serafin C, Morales-Torres J, Sanchez-Ortiz A, Sandoval- Castro C, et al. Sustained clinical remission and rate of relapse after tocilizumab withdrawal in patients with rheumatoid arthritis. J Rheumatol 2013;40:1069-73.
  • 73. Kremer JM, Bloom BJ, Breedveld FC, Coombs JH, Fletcher MP, Gruben D, et al. The safety and efficacy of a JAK inhibitor in patients with active rheumatoid arthritis: Results of a double-blind, placebo-controlled phase IIa trial of three dosage levels of CP-690,550 versus placebo. Arthritis Rheum 2009;60:1895-905.
  • 74. Fleischmann R, Cutolo M, Genovese MC, Lee EB, Kanik KS, Sadis S, et al. Phase IIb dose-ranging study of the oral JAK inhibitor tofacitinib (CP-690,550) or adalimumab monotherapy versus placebo in patients with active rheumatoid arthritis with an inadequate response to disease-modifying antirheumatic drugs. Arthritis Rheum 2012;64:617-29.
  • 75. Kremer JM, Cohen S, Wilkinson BE, Connell CA, French JL, Gomez-Reino J, et al. A phase IIb dose- ranging study of the oral JAK inhibitor tofacitinib (CP-690,550) versus placebo in combination with background methotrexate in patients with active rheumatoid arthritis and an inadequate response to methotrexate alone. Arthritis Rheum 2012;64:970-81.
  • 76. van Vollenhoven RF, Fleischmann R, Cohen S, Lee EB, García Meijide JA, Wagner S, et al. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N Engl J Med 2012;367:508-19.
  • 77. Fleischmann R, Kremer J, Cush J, Schulze-Koops H, Connell CA, Bradley JD, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N Engl J Med 2012;367:495-507.
  • 78. van der Heijde D, Tanaka Y, Fleischmann R, Keystone E, Kremer J, Zerbini C, et al. Tofacitinib (CP-690,550) in patients with rheumatoid arthritis receiving methotrexate: twelve-month data from a twenty- four-month phase III randomized radiographic study. Arthritis Rheum 2013;65:559-70.
  • 79. Lee EB, Fleischmann RM, Hall S, Wilkinson B, Bradley JD, Gruben D, et al. Radiographic, clinical and functional comparison of tofacitinib monotherapy versus methotrexate in methotrexate-naive patients with rheumatoid arthritis. Arthritis Rheum 2012;64:1049.
APA ATAMAN Ş, SÜRMELİ SARI Z, Sunar İ, ÖZDEMİREL E, AKINCI A, BODUR H, Akgul O, ALTAN İNCEOĞLU L, ALTAY Z, AYHAN F, BİRTANE M, BUĞDAYCI SOY D, ÇAPKIN E, CERRAHOĞLU A, DURUÖZ M, GUNAYDIN R, günendi z, gurer g, BAL HASTÜRK A, KAÇAR C, KAPTANOĞLU E, Kaya T, KOCABAŞ H, KOTEVOĞLU N, NAS K, rezvani a, Şen N, ŞENDUR Ö, YALÇIN P (2015). Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. , 271 - 284.
Chicago ATAMAN Şebnem,SÜRMELİ SARI Zühre,Sunar İsmihan,ÖZDEMİREL Erhan,AKINCI Ayşen,BODUR Hatice,Akgul Ozgur,ALTAN İNCEOĞLU LALE,ALTAY ZUHAL,AYHAN Figen,BİRTANE Murat,BUĞDAYCI SOY Derya,ÇAPKIN Erhan,CERRAHOĞLU AYŞE BEYHAN LALE,DURUÖZ Mehmet Tuncay,GUNAYDIN Rezzan,günendi zafer,gurer gülcan,BAL HASTÜRK AJDA,KAÇAR Cahit,KAPTANOĞLU Ece,Kaya Taciser,KOCABAŞ Hilal,KOTEVOĞLU Nurdan,NAS Kemal,rezvani aylin,Şen Nesrin,ŞENDUR Ömer Faruk,YALÇIN Peyman Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. (2015): 271 - 284.
MLA ATAMAN Şebnem,SÜRMELİ SARI Zühre,Sunar İsmihan,ÖZDEMİREL Erhan,AKINCI Ayşen,BODUR Hatice,Akgul Ozgur,ALTAN İNCEOĞLU LALE,ALTAY ZUHAL,AYHAN Figen,BİRTANE Murat,BUĞDAYCI SOY Derya,ÇAPKIN Erhan,CERRAHOĞLU AYŞE BEYHAN LALE,DURUÖZ Mehmet Tuncay,GUNAYDIN Rezzan,günendi zafer,gurer gülcan,BAL HASTÜRK AJDA,KAÇAR Cahit,KAPTANOĞLU Ece,Kaya Taciser,KOCABAŞ Hilal,KOTEVOĞLU Nurdan,NAS Kemal,rezvani aylin,Şen Nesrin,ŞENDUR Ömer Faruk,YALÇIN Peyman Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. , 2015, ss.271 - 284.
AMA ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. . 2015; 271 - 284.
Vancouver ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. . 2015; 271 - 284.
IEEE ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P "Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR." , ss.271 - 284, 2015.
ISNAD ATAMAN, Şebnem vd. "Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR". (2015), 271-284.
APA ATAMAN Ş, SÜRMELİ SARI Z, Sunar İ, ÖZDEMİREL E, AKINCI A, BODUR H, Akgul O, ALTAN İNCEOĞLU L, ALTAY Z, AYHAN F, BİRTANE M, BUĞDAYCI SOY D, ÇAPKIN E, CERRAHOĞLU A, DURUÖZ M, GUNAYDIN R, günendi z, gurer g, BAL HASTÜRK A, KAÇAR C, KAPTANOĞLU E, Kaya T, KOCABAŞ H, KOTEVOĞLU N, NAS K, rezvani a, Şen N, ŞENDUR Ö, YALÇIN P (2015). Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. Archives of Rheumatology, 30(4), 271 - 284.
Chicago ATAMAN Şebnem,SÜRMELİ SARI Zühre,Sunar İsmihan,ÖZDEMİREL Erhan,AKINCI Ayşen,BODUR Hatice,Akgul Ozgur,ALTAN İNCEOĞLU LALE,ALTAY ZUHAL,AYHAN Figen,BİRTANE Murat,BUĞDAYCI SOY Derya,ÇAPKIN Erhan,CERRAHOĞLU AYŞE BEYHAN LALE,DURUÖZ Mehmet Tuncay,GUNAYDIN Rezzan,günendi zafer,gurer gülcan,BAL HASTÜRK AJDA,KAÇAR Cahit,KAPTANOĞLU Ece,Kaya Taciser,KOCABAŞ Hilal,KOTEVOĞLU Nurdan,NAS Kemal,rezvani aylin,Şen Nesrin,ŞENDUR Ömer Faruk,YALÇIN Peyman Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. Archives of Rheumatology 30, no.4 (2015): 271 - 284.
MLA ATAMAN Şebnem,SÜRMELİ SARI Zühre,Sunar İsmihan,ÖZDEMİREL Erhan,AKINCI Ayşen,BODUR Hatice,Akgul Ozgur,ALTAN İNCEOĞLU LALE,ALTAY ZUHAL,AYHAN Figen,BİRTANE Murat,BUĞDAYCI SOY Derya,ÇAPKIN Erhan,CERRAHOĞLU AYŞE BEYHAN LALE,DURUÖZ Mehmet Tuncay,GUNAYDIN Rezzan,günendi zafer,gurer gülcan,BAL HASTÜRK AJDA,KAÇAR Cahit,KAPTANOĞLU Ece,Kaya Taciser,KOCABAŞ Hilal,KOTEVOĞLU Nurdan,NAS Kemal,rezvani aylin,Şen Nesrin,ŞENDUR Ömer Faruk,YALÇIN Peyman Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. Archives of Rheumatology, vol.30, no.4, 2015, ss.271 - 284.
AMA ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. Archives of Rheumatology. 2015; 30(4): 271 - 284.
Vancouver ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR. Archives of Rheumatology. 2015; 30(4): 271 - 284.
IEEE ATAMAN Ş,SÜRMELİ SARI Z,Sunar İ,ÖZDEMİREL E,AKINCI A,BODUR H,Akgul O,ALTAN İNCEOĞLU L,ALTAY Z,AYHAN F,BİRTANE M,BUĞDAYCI SOY D,ÇAPKIN E,CERRAHOĞLU A,DURUÖZ M,GUNAYDIN R,günendi z,gurer g,BAL HASTÜRK A,KAÇAR C,KAPTANOĞLU E,Kaya T,KOCABAŞ H,KOTEVOĞLU N,NAS K,rezvani a,Şen N,ŞENDUR Ö,YALÇIN P "Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR." Archives of Rheumatology, 30, ss.271 - 284, 2015.
ISNAD ATAMAN, Şebnem vd. "Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR". Archives of Rheumatology 30/4 (2015), 271-284.