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Type: Artigo de periódico
Title: 2012 Brazilian Society Of Rheumatology Consensus On The Management Of Comorbidities In Patients With Rheumatoid Arthritis
Author: Pereira I.A.
Mota L.M.H.
Cruz B.A.
Brenol C.V.
Fronza L.S.R.
Bertolo M.B.
Freitas M.V.C.
Silva N.A.
Louzada-Junior P.
Giorgi R.D.N.
Lima R.A.C.
Pinheiro G.R.C.
Abstract: Objective: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA). Methods: To review the literature and the opinions of the SBR RA Committee experts. Results and conclusions: Recommendations: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specific treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities. © 2012 Elsevier Editora Ltda.
Citation: Revista Brasileira De Reumatologia. , v. 52, n. 4, p. 483 - 495, 2012.
Rights: fechado
Identifier DOI: 10.1590/S0482-50042012000400002
Date Issue: 2012
Appears in Collections:Unicamp - Artigos e Outros Documentos

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