Wanruchada KatchamartJosiane Bourré-TessierTimea DonkaJulie DrouinGina RohekarVivian P. BykerkBoulos HaraouiSharon LeClerqDianne P. MosherJanet E. PopeKam ShojaniaJohn ThomsonJ. Carter ThorneClaire BombardierKenneth BlockaCathy Elizabeth FlanaganPaul DavisWojciech OlszynskiVandana AhluwaliaMichel ZummerGilles BoireJamie HendersonBarry KoehlerPhilip BaerZareen AhmadAnne St-PierreMartin CohenMaysan Abu-HakimaMajed KhraishiElaine SoucyJacob KarshUniversity of TorontoMahidol UniversityCentre Hospitalier de L'Universite de MontrealWestern UniversityUniversity of CalgaryDalhousie UniversitySt. Joseph's Health Care LondonThe University of British ColumbiaUniversity of Ottawa, CanadaThe Arthritis Program Research Group Inc.Toronto General Research Institute University of Toronto2018-09-242018-09-242010-07-01Journal of Rheumatology. Vol.37, No.7 (2010), 1422-14300315162X2-s2.0-77954445906https://repository.li.mahidol.ac.th/handle/20.500.14594/29215Objective. To develop recommendations for the use of methotrexate (MTX) in patients with rheumatoid arthritis. Methods. Canadian rheumatologists who participated in the international 3e Initiative in Rheumatology (evidence, expertise, exchange) in 2007-2008 formulated 5 unique Canadian questions. A bibliographic team systematically reviewed the relevant literature on these 5 topics. An expert committee consisting of 26 rheumatologists from across Canada was convened, and a set of recommendations was proposed based on the results of systematic reviews combined with expert opinions using a nominal group consensus process. Results. The 5 questions addressed drug interactions, predictors of response, strategies to reduce non-serious side effects, variables to assess clinical response, and incorporating patient preference into decision-making. The systematic review retrieved 93 pertinent articles; this evidence was presented to the expert committee during the interactive workshop. After extensive discussion and voting, a total of 9 recommendations were formulated: 2 on drug interactions, 1 on predictors of response, 2 on strategies to reduce non-serious side effects, 3 on variables to assess clinical response, and 1 on incorporating patient preferences into decision-making. The level of evidence and the strength of recommendations are reported. Agreement among panelists ranged from 85% to 100%. Conclusion. Nine recommendations pertaining to the use of MTX in daily practice were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. The Journal of Rheumatology Copyright © 2010. All rights reserved.Mahidol UniversityImmunology and MicrobiologyMedicineReviewSCOPUS10.3899/jrheum.090978