Table 3 Adoloped recommendations and Evidence to Decision (EtD) criteria driving any modification
Adoloped recommendations | Difference in relation to the source recommendations | EtD criteria driving any modification | |
|---|---|---|---|
Direction | Certainty | ||
1. Initiation of treatment in DMARD-naive patients with low disease activity, sulfasalazine is conditionally recommended over methotrexate (conditional recommendation; based on very low certainty evidence) | Modified (from conditional in favor of SSZ) | Unmodified | • Balance of effects • Cost • Acceptability in relation to dosing conveniencea |
2. Initiation of treatment in DMARD-naive patients with low disease activity, hydroxychloroquine is conditionally recommended over other csDMARDs (conditional recommendation; based on very low certainty evidence) | Unmodified | Unmodified | |
3. Initiation of a csDMARD without short-term (< 3 months) glucocorticoids is conditionally recommended over initiation of csDMARD with short-term glucocorticoids (conditional recommendation; based on very low certainty evidence) | Modified (from conditional against glucocorticoids) | Unmodified | • Valuation of outcomes • Balance of effects |
4. For patients taking oral methotrexate who are not at target, a switch to subcutaneous methotrexate is conditionally recommended over addition/switch to alternative DMARD(s) (conditional recommendation; based on very low certainty evidence) | Unmodified | Unmodified | |
5. For patients taking methotrexate plus a bDMARD or tsDMARD who wish to discontinue a DMARD, gradual discontinuation of methotrexate is conditionally recommended over gradual discontinuation of the bDMARD or tsDMARD (conditional recommendation; based on very low certainty evidence) | Unmodified | Modified (from very low) | |