16 July 2024
The publication of the scope for the update to our conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) guideline presents the expansion to a whole-life course approach, from childhood to adulthood. This expansion will inform the revision of key recommendations to healthcare providers, improving the outcomes of all people impacted across the spectrum of autoimmune rheumatic diseases.
Since the previous 2017 , there has been considerable development in the understanding and clinical practices involving non-biologic DMARDs for the treatment of autoimmune rheumatic diseases. The updated guideline will include recommendations around the use of voclosporin, which has recently been approved for use in the UK, and will consider recent work on recommended blood monitoring schedules, the impact of methotrexate on ILD, and changes to the recommended dose of hydroxychloroquine.
Guideline working group (GWG) chair and Rheumatology Consultant, Louise Mercer, said:
鈥淭he SARS鈥揅oV2 (COVID-19) pandemic has led to an explosion of interest in the need for and timing of vaccination in people exposed to DMARDs. New vaccines against COVID-19 and shingles have been made available since the 2017 guidelines were published. The literature around optimum timing of vaccination and impact, if any, on omitting DMARD doses will be reviewed.鈥�
The updated guideline is needed to reflect these advancements and provide more contemporary, evidence-based recommendations.
A plain language summary accompanies the scope. This offers a concise, plain English overview of what this guideline update will mean for patients. Akhila Kavirayani, Paediatric Rheumatology Consultant leading the paediatric and adolescent sections of the guideline explained:
鈥淎 revised guideline will aim to provide up-to-date information for the safe prescribing and monitoring of the effects of non-biologic DMARDs, based on best available evidence and expert consensus. This guideline is intended for use by healthcare professionals, people living with autoimmune rheumatic diseases and other stakeholders, such as patient groups and charities. The revised guideline for DMARD safety will be updated to include new information and is being extended to include children and young people. Guideline revisions will be undertaken by a working group of adult and paediatric and adolescent rheumatologists, allied healthcare professionals and experts by experience.鈥�
The DMARD guideline update will cover pharmacological management, treatment monitoring, and patient education. For more details on what the guideline will cover, read the full scope in the BSR open-access journal, Rheumatology Advances in Practice, .
The updated guideline, which is expected to publish in 2025, will be developed using the methods and processes outlined in the 香港六合彩直播开奖鈥檚 'Creating clinical guidelines; Our protocol'. Access all the BSR guidelines and a range of helpful related resources via the guidelines homepage.