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Cited by 491

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

Open access
Visser, K, Katchamart, W, Loza, E, Martinez-Lopez, J A, Salliot, C, Trudeau, J, Bombardier, C, Carmona, L, van der Heijde, D, Bijlsma, J W J, Boumpas, D T, Canhao, H, Edwards, C J, Hamuryudan, V, Kvien, T K, Leeb, B F, Martín-Mola, E M, Mielants, H, Müller-Ladner, U, Murphy, G, Østergaard, M, Pereira, I A, Ramos-Remus, C, Valentini, G, Zochling, J, Dougados, M·2009·Annals of the Rheumatic Diseases

Abstract

OBJECTIVES: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. METHODS: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. RESULTS: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases. CONCLUSIONS: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use.

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Metadata

Authors
Visser, K., Katchamart, W., Loza, E., Martinez-Lopez, J. A., Salliot, C., Trudeau, J., Bombardier, C., Carmona, L., van der Heijde, D., Bijlsma, J. W. J., Boumpas, D. T., Canhao, H., Edwards, C. J., Hamuryudan, V, Kvien, T. K., Leeb, B. F., Martín-Mola, E. M., Mielants, H., Müller-Ladner, U., Murphy, G., Østergaard, M., Pereira, I. A., Ramos-Remus, C., Valentini, G., Zochling, J., & Dougados, M.
Venue
Annals of the Rheumatic Diseases
Publisher
Elsevier BV
Published
2009-07
Volume
68
Issue
7
Pages
1086-1093
ISSN
0003-4967 (ISSN-L)
OpenAlex
W2146502982
Cited by
491
References
1
FWCI
20.10
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. https://app.cochat.ai/papers/10.1136/ard.2008.094474
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Visser, K., Katchamart, W., Loza, E., Martinez-Lopez, J. A., Salliot, C., Trudeau, J., Bombardier, C., Carmona, L., van der Heijde, D., Bijlsma, J. W. J., Boumpas, D. T., Canhao, H., Edwards, C. J., Hamuryudan, V, Kvien, T. K., Leeb, B. F., Martín-Mola, E. M., Mielants, H., Müller-Ladner, U., . . . Dougados, M. (2009). Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Annals of the Rheumatic Diseases. https://doi.org/10.1136/ard.2008.094474

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.