Italian consensus on the recommendations about the use of methotrexate for the treatment of rheumatic diseases with a focus on rheumatoid arthritis: results from the “3E initiative”

• Main Authors: C. Montecucco, G.F. Ferraccioli, S. Bombardieri, A.M. Buono, E. Bonacci, S. Aliverini, F. De Leonardis, L. Sinigaglia, F. Trotta, G. Valentini
• Format: Article
• Language: English
• Published: PAGEPress Publications 2011-06-01
• Series: Reumatismo
• Online Access: http://www.reumatismo.org/index.php/reuma/article/view/461
• ISSN: 0048-7449; 2240-2683

Objective: To develop a set of national evidence-based recommendations for the use of Methotrexate (MTX) in daily clinical practice. Methods: A panel of 37 Italian Rheumatologists reviewed 10 international recommendations formulated during the “3E (Evidence, Expertise, Exchange) initiative” for the year 2007-8, following a systematic literature search in Medline, Embase, Cochrane Library, and 2005-7 American College of Rheumatology/European League Against Rheumatism meeting abstracts and the revision of selected papers and the appraisal of Oxford levels of evidence. Moreover, the same panel by the same methodology formulated further 5 recommendations on topics previously selected by Italian representatives to 3E initiative. The agreement about the set of proposed recommendations was stated by a consensus process and the potential impact on clinical practice was assessed. Results: International Recommendations were analysed and changed when appropriate. In addition, 5 national recommendations were developed by identifying 6371 references, selecting and evaluating the 29 ones satisfying Evidence Based Medicine principles. Conclusions: A set of 15 national recommendations for the use of MTX in daily clinical practice was developed. These recommendations are evidence-based and integrate the expertise of a large panel of Italian rheumatologists.