Research agenda
| Research agenda | |
|---|---|
| 1 | What is the efficacy of GCs when added to DMARDs other than MTX or combinations of synthetic DMARDs with MTX, such as GC plus SSZ, compared with GC plus MTX and biological agents+MTX? |
| 2 | How comparable or different is the efficacy of the various biological agents in patients with active disease despite MTX? |
| 3 | How comparable or different is the efficacy of the various biological agents in patients who did not respond or lost response to TNF inhibitors? |
| 4 | Can biological agents be stopped in sustained remission with maintenance of remission, and how does stopping biological agents compare with stopping GC plus MTX or stopping GC? |
| 5 | What is the best way to taper treatment with synthetic and biological DMARDs in patients with longstanding remission? (comparison of different tapering ways) |
| 6 | Which differences will exist when comparing treatment strategies starting in parallel with MTX monotherapy plus GC, combination of synthetic DMARDs including MTX plus GC, combination of synthetic DMARDs including MTX without GC and biological agents plus MTX? |
| 7 | How big is the difference of clinical, functional, radiographic efficacy when a treatment strategy aiming at remission by newly defined ACR/EULAR remission criteria is compared with a strategy aiming at achievement of low disease activity? |
| 8 | Can we find predictors of response to synthetic DMARDs and different biological agents? |
| 9 | What is the effect of adding antimalarial drugs to MTX or to MTX+SSZ? |
| 10 | How cost effective is treating individuals with exceptionally high risk of rapid progression with biological agents versus synthetic DMARDs plus GCs when compared with using a sequence of agents as mandated by social security agencies or NICE? |
This research agenda is partly based on recommendations derived by expert opinion for which sufficient evidence is lacking.
ACR/EULAR, American College of Rheumatology/European League Against Rheumatism; DMARD, disease-modifying antirheumatic drug; GCs, glucocorticoids; MTX, methotrexate; NICE, National Institute of Health and Clinical Excellence; SSZ, sulfasalazine; TNF, tumour necrosis factor.