The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized
by arterial and venous thrombosis, gestational morbidity and presence of elevated and
persistently positive serum titers of antiphospholipid antibodies. The treatment of APS is
still controversial, because any therapeutic decision potentially faces the risk of an insuffi cient or excessive antithrombotic coverage associated with anticoagulation and its major
adverse effects. This guideline was elaborated from nine relevant clinical questions related
to the treatment of APS by the Committee of Vasculopathies of the Brazilian Society of
Rheumatology. Thus, this study aimed at establishing a guideline that included the most
relevant and controversial questions in APS treatment, based on the best scientifi c evidence available. The questions were structured by use of the PICO (patient, intervention or
indicator, comparison and outcome) process, enabling the generation of search strategies
for evidence in the major primary scientifi c databases (MEDLINE/PubMed, Embase, Lilacs,
Scielo, Cochrane Library, Premedline via OVID). A manual search for evidence and theses
was also conducted (BDTD and IBICT). The evidence retrieved was selected based on critical assessment by using discriminatory instruments (scores) according to the category of
the therapeutic question (JADAD scale for randomized clinical trials and Newcastle-Ottawa
scale for non-randomized studies). After defining the potential studies to support the recommendations, they were selected according to level of evidence and grade of recommendation, according to the Oxford classification.
http://www.scielo.br/pdf/rbr/v53n2/en_v53n2a05.pdf
by arterial and venous thrombosis, gestational morbidity and presence of elevated and
persistently positive serum titers of antiphospholipid antibodies. The treatment of APS is
still controversial, because any therapeutic decision potentially faces the risk of an insuffi cient or excessive antithrombotic coverage associated with anticoagulation and its major
adverse effects. This guideline was elaborated from nine relevant clinical questions related
to the treatment of APS by the Committee of Vasculopathies of the Brazilian Society of
Rheumatology. Thus, this study aimed at establishing a guideline that included the most
relevant and controversial questions in APS treatment, based on the best scientifi c evidence available. The questions were structured by use of the PICO (patient, intervention or
indicator, comparison and outcome) process, enabling the generation of search strategies
for evidence in the major primary scientifi c databases (MEDLINE/PubMed, Embase, Lilacs,
Scielo, Cochrane Library, Premedline via OVID). A manual search for evidence and theses
was also conducted (BDTD and IBICT). The evidence retrieved was selected based on critical assessment by using discriminatory instruments (scores) according to the category of
the therapeutic question (JADAD scale for randomized clinical trials and Newcastle-Ottawa
scale for non-randomized studies). After defining the potential studies to support the recommendations, they were selected according to level of evidence and grade of recommendation, according to the Oxford classification.
http://www.scielo.br/pdf/rbr/v53n2/en_v53n2a05.pdf
No comments:
Post a Comment