<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000300103</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Guías de manejo de artritis reumatoide Consenso 2016 Asociación Costarricense de Reumatología]]></article-title>
<article-title xml:lang="en"><![CDATA[Management Guidelines of Rheumatoid Arthritis Consensus 2016]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alpízar-Campos]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Coto]]></surname>
<given-names><![CDATA[José Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vega-Ortiz]]></surname>
<given-names><![CDATA[José Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monge-Zeledón]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arrieta-Vega]]></surname>
<given-names><![CDATA[Dina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sáenz-Castro]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital &#8220;Dr. Maximiliano Peralta Jiménez&#8221; Unidad de Reumatología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital México Servicio de Reumatología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,aff3  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Caja Costarricense de Seguro Social Servicio de Reumatología Dr. Rafael Ángel Calderón Guardia]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>3</numero>
<fpage>103</fpage>
<lpage>109</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000300103&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000300103&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000300103&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La artritis reumatoide sigue representando un importante factor de deterioro de la salud de las personas que sufren esta condición, a pesar de los avances recientes en su tratamiento. En forma adicional, se reconoce su significativo impacto a nivel social y económico. La Asociación Costarricense de Reumatología publicó en 2010, las primeras guías de manejo de esta enfermedad. En el presente trabajo, este primer documento fue actualizado, mediante la revisión exaustiva de la información científica disponible y relevante a la fecha, con el objetivo de uniformar y optimizar la atención de la artritis reumatoide en Costa Rica. Incluye las recomendaciones de evaluación de los pacientes, su seguimiento y tratamiento. También se revisan las opciones de medicamentos disponibles en el país, es decir, drogas modificadoras de los síntomas y fármacos modificadores de la enfermedad convencionales, además de agentes biológicos y moléculas pequeñas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Rheumatoid arthritis continues to represent an important factor of deterioration in the health of people suffering from this condition despite recent medical advances in their treatment. Additionally, its significant social and economic impact it is recognized. The Costa Rican Association of Rheumatology published in 2010 the first guidelines for the management of this disease. In the present work, this first document is updated, through an exhaustive review of the available and relevant scientific information to date. This review aims to standardize and optimize the care of rheumatoid arthritis in Costa Rica. It includes recommendations for evaluation of patients, follow-up and treatment. There is also a review of drug options available in the country, i.e., symptoms-modifying drugs, conventional disease modifying drugs, as well as biological agents and small molecules.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[artritis reumatoide]]></kwd>
<kwd lng="es"><![CDATA[guías de manejo]]></kwd>
<kwd lng="es"><![CDATA[clinimetría]]></kwd>
<kwd lng="es"><![CDATA[terapia biológica]]></kwd>
<kwd lng="en"><![CDATA[rheumatoid arthritis]]></kwd>
<kwd lng="en"><![CDATA[management guides]]></kwd>
<kwd lng="en"><![CDATA[clinimetrics]]></kwd>
<kwd lng="en"><![CDATA[biological therapy]]></kwd>
</kwd-group>
</article-meta>
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