Document Detail

2012 Brazilian Society of Rheumatology Consensus on the management of comorbidities in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  22885417     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA).
METHODS: To review the literature and the opinions of the SBR RA Committee experts.
RECOMMENDATIONS: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specific treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities.
Ivânio Alves Pereira; Licia Maria Henrique da Mota; Boris Afonso Cruz; Claiton Viegas Brenol; Lucila Stange Rezende Fronza; Manoel Barros Bertolo; Max Victor Carioca de Freitas; Nilzio Antônio da Silva; Paulo Louzada-Junior; Rina Dalva Neubarth Giorgi; Rodrigo Aires Corrêa Lima; Geraldo da Rocha Castelar Pinheiro;
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Publication Detail:
Type:  Consensus Development Conference; Journal Article; Practice Guideline    
Journal Detail:
Title:  Revista brasileira de reumatologia     Volume:  52     ISSN:  1809-4570     ISO Abbreviation:  Rev Bras Reumatol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-13     Completed Date:  2012-12-31     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0404256     Medline TA:  Rev Bras Reumatol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  474-95     Citation Subset:  IM    
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MeSH Terms
Arthritis, Rheumatoid / complications*,  diagnosis,  therapy*
Erratum In:
Rev Bras Reumatol. 2012 Oct;52(5):815

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