Rheumatology (Oxford, England) · 2026
The development of a risk threshold to aid risk stratified approach to monitoring for haematological, hepatic and/or renal adverse drug reactions during established cs DMARD treatment for systemic autoimmune rheumatic diseases: a RAND/UCLA Appropriateness Method consensus study.
СтатьяConsensus StatementНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ablewhite Joanne, Nakafero Georgina, Almayahi Abdullah, Bechman Katie, Ahmed Alison, Davidson Alan, De Vere Hope, Dhillon Emmandeep, Foulkes Amy, Gullick Nicola, Heaton Rebecca, Hider Samantha, Kyle Stuart, Nowak Kataryzna, Rose-Parfitt Emily, Ryan Sarah, Tan Su Yin, Wood Natasha, Zebate Genevieve, Parsons Kate, Holmes Julia, Twohigg Helen, Reynolds John A, Mercer Louise, Galloway James, Abhishek Abhishek
Аннотация
OBJECTIVE: To explore how appropriate different intervals between monitoring blood tests are considered in relation to the risk of clinically significant adverse drug reactions in adults prescribed conventional synthetic DMARDs (csDMARDs) for ≥1 year for systemic autoimmune rheumatic diseases (SARD).
METHODS: A RAND/UCLA Appropriateness Method consensus study was undertaken. Members of the BSR csDMARD guideline working group who manage adults with SARD participated. Experts rated the extent to which intervals between blood tests were appropriate using Likert-type scales with responses from 1 (totally inappropriate) to 9 (totally appropriate) for nine scenarios with 5-year predicted risk of discontinuing treatment due to abnormal monitoring blood tests from 5% to 25%. Median score and the number that voted 1-3 (inappropriate), 4-6 (unsure) and 7-9 (appropriate) were calculated for every interval in each scenario. Scenarios for which agreement could not be reached in the first round were recirculated, enclosing individual round 1 response and the panel median score. Consensus that an interval was appropriate for a scenario was reached where the median panel score was ≥7 and up to six experts rated <7. The results were discussed with patient and public involvement members and experts.
RESULTS: Twenty-one of the 27 invitees participated. They comprised 11 consultants/GPs, five specialist nurses, three pharmacists and two rheumatology specialty trainees. Consensus was reached for all scenarios. Six- and three-monthly blood tests were agreed as appropriate when the predicted risk was ≤10% and >10% over 5 years, respectively.
CONCLUSION: A threshold to aid risk-stratified monitoring during established csDMARD treatment was agreed for adults with SARD.
METHODS: A RAND/UCLA Appropriateness Method consensus study was undertaken. Members of the BSR csDMARD guideline working group who manage adults with SARD participated. Experts rated the extent to which intervals between blood tests were appropriate using Likert-type scales with responses from 1 (totally inappropriate) to 9 (totally appropriate) for nine scenarios with 5-year predicted risk of discontinuing treatment due to abnormal monitoring blood tests from 5% to 25%. Median score and the number that voted 1-3 (inappropriate), 4-6 (unsure) and 7-9 (appropriate) were calculated for every interval in each scenario. Scenarios for which agreement could not be reached in the first round were recirculated, enclosing individual round 1 response and the panel median score. Consensus that an interval was appropriate for a scenario was reached where the median panel score was ≥7 and up to six experts rated <7. The results were discussed with patient and public involvement members and experts.
RESULTS: Twenty-one of the 27 invitees participated. They comprised 11 consultants/GPs, five specialist nurses, three pharmacists and two rheumatology specialty trainees. Consensus was reached for all scenarios. Six- and three-monthly blood tests were agreed as appropriate when the predicted risk was ≤10% and >10% over 5 years, respectively.
CONCLUSION: A threshold to aid risk-stratified monitoring during established csDMARD treatment was agreed for adults with SARD.