Procedures on Rheumatoid Arthritis Management by Rheumatologists in Morocco
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 3
Abstract
Abstract: This work aim is to assess procedures used by Moroccan rheumatologists in managing rheumatoid arthritis in order to check levels of adherence to the recommendations put forth by the Moroccan Rheumatology Association (SMR). A questionnaire was developed, validated by a committee of experts and then sent to all Moroccan rheumatologists. The questionnaire was produced in Google forms and e-mailed to them on three occasions between October and November 2015. The questionnaire included a set of multiple choice questions as well as clinical cases reviewing the various items of the recommendations of SMR. The degree of adherence to recommendations is rated on an assessment scale. Amongst the 300 rheumatologists practicing in Morocco, only 235 had a valid email address. The participation rate was 32.3%. The proportion of patients consulting for early RA (less than 3 months) was 26%. Basic treatment was started by 96% of the rheumatologists. Methotrexate (MTX) was used in 94.4% of the cases in combination with oral corticosteroid therapy in half of the patients involved. Half of rheumatologists ensured follow-up in a systematic fashion using baseline DAS 28. If therapeutic failure of seronegative non erosive RA due to inadequate response to MTX occures, 92.8% of the physicians optimized the MTX dose up to 25 mg per day and 64.2% proposed a combination of (MTX+Sulafasalzin+Hydroxychloroquin).However, in case of therapeutic failure of a severely active, seropositive erosive RA treated with MTX, 67.6% offered biotherapy. The proportion of patients with RA who received biotherapy treatment was 24%. In 64.3% of the cases, Rituximab was used as first-line therapy. In patients who have failed a first anti-TNF therapy, 52.6% of rheumatologists proposed another anti-TNF agent. Only 37% of rheumatologists were able to stop corticosteroid, 81.3% continued prescribing substantive treatment while 60% managed to stop biological therapy. Only 38.2% routinely vaccinated their patients.
Authors and Affiliations
Mirieme Ghazi, Anass Kherrab, Sara Elrharras, Radouane Niamane
Keywords
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