2024 update of the recommendations of the French Society of Rheumatology for the diagnosis and management of patients with rheumatoid arthritis

• DOI: 10.1016/j.jbspin.2024.105790
• Publication Date: 2024-10-09T19:43:14Z
• Authors: Bruno Fautrel; Joanna Kedra; Pierre-Antoine Juge; Claire Rempenault; Juliette Drouet; Jérôme Avouac; Athan Baillet; Olivier Brocq; Guillermo Carvaja...; Arnaud Constantin; Emmanuelle Dernis; Cécile Gaujoux-Viala; Vincent Goëb; Jacques-Eric Gott...; Benoit Le Goff; Hubert Marotte; Christophe Richez; Jean-Hugues Salmon; Alain Saraux; Eric Senbel; Raphaèle Seror; Anne Tournadre; Olivier Vittecoq; Pascale Escaffre; Danielle Vacher; Philippe Dieudé; Claire Daien
• Keywords: [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system; JAK inhibitors; [SDV]Life Sciences [q-bio]; 610; Interstitial lung disease; Therapeutics; Biologics; Management; Recommendations for clinical practice; DMARD; Targeted therapies; [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system; 616; People at risk of rheumatoid arthritis; Rheumatoid arthritis

The French Society of Rheumatology recommendations for managing rheumatoid arthritis (RA) has been updated by a working group of 21 rheumatology experts, 4 young rheumatologists and 2 patient association representatives on the basis of the 2023 version of the European Alliance of Associations for Rheumatology (EULAR) recommendations and systematic literature reviews. Two additional topics were addressed: people at risk of RA development and RA-related interstitial lung disease (RA-ILD). Four general principles and 19 recommendations were issued. The general principles emphasize the importance of a shared decision between the rheumatologist and patient and the need for comprehensive management, both drug and non-drug, for people with RA or at risk of RA development. In terms of diagnosis, the recommendations stress the importance of clinical arthritis and in its absence, the risk factors for progression to RA. In terms of treatment, the recommendations incorporate recent data on the cardiovascular and neoplastic risk profile of Janus kinase inhibitors. With regard to RA-ILD, the recommendations highlight the importance of clinical screening and the need for high-resolution CT scan in the presence of pulmonary symptoms. RA-ILD management requires collaboration between rheumatologists and pulmonologists. The treatment strategy is based on controlling disease activity with methotrexate or targeted therapies (mainly abatacept or rituximab). The prescription for anti-fibrotic treatment should be discussed with a pulmonologist with expertise in RA-ILD.