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How are rheumatologists from Argentina managing patients with arthralgias suspicious for progressing to rheumatoid arthritis? | LitMetric

AI Article Synopsis

  • Argentinean rheumatologists face challenges in managing patients with arthralgias who may progress to rheumatoid arthritis (RA), as there is a lack of clear treatment recommendations.
  • An anonymous survey of 522 rheumatologists revealed that 97.6% have seen patients seeking evaluations to rule out RA, with ultrasound being the most preferred diagnostic tool (93.7%).
  • Among those found to have joint inflammation through ultrasound, 58.1% of rheumatologists would typically prescribe methotrexate as the first line of treatment; however, the study emphasizes the need for more formal management guidelines despite existing clinical trial data.

Article Abstract

Patients with arthralgias who could be at risk of progressing to rheumatoid arthritis (RA) represent a clinical challenge. Recommendations for their management and treatment are lacking. The purpose of the present study was to determine how Argentinean rheumatologists deal with these patients. We developed an anonymous ad hoc survey which was sent to 522 Argentinean rheumatologists. The RA study group of our Argentinean Rheumatology National Society assisted in forwarding the surveys to its members via the internet (e-mail or WhatsApp). The findings of the collected data are presented as descriptive statistics. The questionnaires were completed by 255 rheumatologists (overall response rate of 48.9%), and 97.6% confirmed that their practices had received medical consultations to rule out RA in patients with arthralgias. Ultrasound (US) was the method of first choice (93.7%) as part of the evaluation of these patients. For those in whom US power Doppler signal was present in at least one joint, 93.7% of the participants would start treatment and methotrexate was the first choice (58.1%). In patients with tenosynovitis but no synovitis on US, most rheumatologists would start treatment (89.4%), being NSAIDs the drug of first choice (52.3%). Argentinean rheumatologists evaluate patients with imminent RA and treat them based on their clinical judgment and findings from the US evaluation of affected joints; the drug of first choice for these patients among these rheumatologists was methotrexate. Despite published data of recent clinical trials, recommendations for the management and treatment of these patients are necessary.

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Source
http://dx.doi.org/10.1007/s10067-023-06581-0DOI Listing

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