Canadian Rheumatology Association Living Guidelines for Rheumatoid Arthritis: Update #1

Summary: An evidence-based approach is the gold standard for health decision-making, but the use of the GRADE approach for strong recommendations is inappropriate in cases where the evidence is indirect. We found widespread use of GPS in COVID-19 related recommendations, but guideline developers failed to transparently report their development process. We propose improvements to the operationalization of the GRADE guidance for GPS, including a structured process and standardized reporting.

Summary: This article introduces the initial installment of a practical guideline for pharmacological management of patients with rheumatoid arthritis in Canada. The guideline, developed by a multidisciplinary panel, provides recommendations for tapering biologic and targeted synthetic disease-modifying antirheumatic drugs. The guideline emphasizes shared decision-making and addresses issues related to patient access to rheumatology care and medication.