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Guidelines and Position Articles of the Brazilian Society of Rheumatology

New Content ItemThese guidelines have been prepared by member committees within the Brazilian Society of Rheumatology consisting of experienced researchers and clinicians who revised, analyzed and discussed the literature in order to provide the best evidence-based recommendations for a given diagnosis or treatment in the field of Rheumatology. None of these guidelines have been sponsored by pharmaceutical companies. All of them have been peer-reviewed by independent referees.

  1. The risk of tuberculosis infection (TBI) and its progression to tuberculosis disease (TBD) among persons with immune-mediated inflammatory diseases (IMID) results from a complex interplay of patient and diseas...

    Authors: Viviane Angelina de Souza, Ana Luiza Mendes Amorim Caparroz, Virginia Fernandes Moça Trevisani, Anna Carolina Faria Moreira Gomes Tavares, Ana Karla Guedes de Melo, Anete Trajman, Ana Cristina de Medeiros-Ribeiro, Marcelo de Medeiros Pinheiro, Ricardo Machado Xavier, Odirlei Andre Monticielo, Maria Fernanda Brandão de Resende Guimarães, Flavio Sztajnbok, Sidney Bombarda, Liliana Andrade Chebli, Adriana Maria Kakehasi, Ana Luiza Bierrenbach…
    Citation: Advances in Rheumatology 2025 65:18
    Content type: Guideline Published on:

  2. Neurological and psychiatric manifestations occur in patients with primary Sjogren’s disease (SjD) with a wide-ranging clinical presentation, affecting quality of life, social participation, and prognosis. Des...

    Authors: Fabiola Reis de Oliveira, Simone Appenzeller, Sandra Gofinet Pasoto, Marilena Leal Mesquita Silvestre Fernandes, Maria Lucia Lemos Lopes, Sonia Cristina de Magalhães Souza Fialho, Aysa Cesar Pinheiro, Laura Caldas dos Santos, Valeria Valim, Erica Vieira Serrano, Sandra Lucia Euzébio Ribeiro, Tatiana Nayara Libório‑Kimura, Danielle Christinne Soares do Egypto, Diego Ustárroz Cantali, Juliana D’Agostino Gennari, Samira Tatiyama Miyamoto…
    Citation: Advances in Rheumatology 2025 65:7
    Content type: Position Statement Published on:

  4. Clinical practice guidelines (CPG) are developed to align standards of health care around the world, aiming to reduce the incidence of misconducts and enabling more effective use of health resources. Consideri...

    Authors: Ana Karla Guedes de Melo, Ana Luíza Mendes Amorim Caparroz, Mirhelen Mendes de Abreu, Daniela Castelo Azevedo, Leonardo Santos Hoff, Sérgio Candido Kowalski, Themis Mizerkowski Torres, Solange Murta Barros, Gilda Aparecida Ferreira, Odirlei André Montecielo, Ricardo Machado Xavier and Virgínia Fernandes Moça Trevisani
    Citation: Advances in Rheumatology 2023 63:12
    Content type: Review Published on:

  5. Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varyin...

    Authors: Virginia Fernandes Moça Trevisani, Aysa César Pinheiro, Sonia Cristina de Magalhães Souza Fialho, Marilena Leal Mesquita Silvestre Fernandes, Alisson Pugliesi, Sandra Gofinet Pasoto, Maria Lucia Lemos Lopes, Lissiane Karine Noronha Guedes, Samira Tatiyama Miyamoto, Laura Caldas dos Santos, Simone Appenzeller, Tania Fidelix, Sandra Lúcia Euzébio Ribeiro, Danielle Christinne Soares Egypto de Brito, Tatiana Nayara Libório-Kimura, Maria Carmen Lopes Ferreira Silva Santos…
    Citation: Advances in Rheumatology 2022 62:35
    Content type: Position article and guidelines Published on:

  7. Sjogren's Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varyin...

    Authors: Virginia Fernandes Moça Trevisani, Alisson Pugliesi, Sandra Gofinet Pasoto, Maria Lucia Lemos Lopes, Lissiane Karine Noronha Guedes, Samira Tatiyama Miyamoto, Marilena Leal Mesquita Silvestre Fernandes, Sonia Cristina de Magalhães Souza Fialho, Aysa César Pinheiro, Laura Caldas dos Santos, Simone Appenzeller, Tania Fidelix, Sandra Lúcia Euzébio Ribeiro, Danielle Christinne Soares Egypto de Brito, Tatiana Nayara Libório-Kimura, Maria Carmen Lopes Ferreira Silva Santos…
    Citation: Advances in Rheumatology 2022 62:18
    Content type: Position article and guidelines Published on:

  8. Authors: Fabiola Reis Oliveira, Valeria Valim, Sandra Gofnet Pasoto, Marilena Leal Mesquita Silvestre Fernandes, Maria Lucia Lemos Lopes, Sonia Cristina de Magalhães Souza Fialho, Aysa César Pinheiro, Laura Caldas dos Santos, Simone Appenzeller, Tania Fidelix, Sandra Lucia Euzébio Ribeiro, Danielle Christinne Soares Egypto de Brito, Tatiana Libório, Maria Carmen Lopes Ferreira Silva Santos, Leandro Tanure, Juliana DAgostino Gennari…
    Citation: Advances in Rheumatology 2022 62:8
    Content type: Correction Published on:

    The original article was published in Advances in Rheumatology 2021 61:54

  9. To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice b...

    Authors: Anna Carolina Faria Moreira Gomes Tavares, Ana Karla Guedes de Melo, Vítor Alves Cruz, Viviane Angelina de Souza, Joana Starling de Carvalho, Ketty Lysie Libardi Lira Machado, Lilian David de Azevedo Valadares, Edgard Torres dos Reis Neto, Rodrigo Poubel Vieira de Rezende, Maria Fernanda Brandão de Resende Guimarães, Gilda Aparecida Ferreira, Alessandra de Sousa Braz, Rejane Maria Rodrigues de Abreu Vieira, Marcelo de Medeiros Pinheiro, Sandra Lúcia Euzébio Ribeiro, Blanca Elena Gomes Rios Bica…
    Citation: Advances in Rheumatology 2022 62:3
    Content type: Position article and guidelines Published on:

  10. Rheumatoid arthritis (RA) is a chronic and autoimmune systemic inflammatory disease that can cause irreversible joint deformities, with increased morbidity and mortality and a significant impact on the quality...

    Authors: Karina Rossi Bonfiglioli, Licia Maria Henrique da Mota, Ana Cristina de Medeiros Ribeiro, Adriana Maria Kakehasi, Ieda Maria Magalhães Laurindo, Rina Dalva Neubarth Giorgi, Angela Luzia Branco Pinto Duarte, Ana Paula Monteiro Gomides Reis, Mariana Peixoto Guimarães Ubirajara e Silva de Souza, Claiton Viegas Brenol, Geraldo da Rocha Castelar Pinheiro, Cleandro Pires de Albuquerque, Charlles Heldan de Moura Castro, Gustavo Luiz Behrens Pinto, Jose Fernando Verztman, Luciana Feitosa Muniz…
    Citation: Advances in Rheumatology 2021 61:70
    Content type: Position article and guidelines Published on:

  11. Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutane...

    Authors: Sueli Carneiro, Penelope Esther Palominos, Sônia Maria Alvarenga Anti, Rodrigo Luppino Assad, Rafaela Silva Guimarães Gonçalves, Adriano Chiereghin, Andre Marun Lyrio, Antônio Carlos Ximenes, Carla Gonçalves Saad, Célio Roberto Gonçalves, Charles Lubianca Kohem, Cláudia Diniz Lopes Marques, Cláudia Goldenstein Schainberg, Eduardo de Souza Meirelles, Gustavo Gomes Resende, Lenise Brandao Pieruccetti…
    Citation: Advances in Rheumatology 2021 61:69
    Content type: Review Published on:

  12. Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and ...

    Authors: Fabiola Reis Oliveira, Valeria Valim, Sandra Gofinet Pasoto, Marilena Leal Mesquita Silvestre Fernandes, Maria Lucia Lemos Lopes, Sonia Cristina de Magalhães Souza Fialho, Aysa César Pinheiro, Laura Caldas dos Santos, Simone Appenzeller, Tania Fidelix, Sandra Lucia Euzébio Ribeiro, Danielle Christinne Soares Egypto de Brito, Tatiana Libório, Maria Carmen Lopes Ferreira Silva Santos, Leandro Tanure, Juliana DAgostino Gennari…
    Citation: Advances in Rheumatology 2021 61:54
    Content type: Position article and guidelines Published on:

    The Correction to this article has been published in Advances in Rheumatology 2022 62:8

  13. Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonstero...

    Authors: Ricardo da Cruz Lage, Claudia Diniz Lopes Marques, Thauana Luiza Oliveira, Gustavo Gomes Resende, Charles Lubianca Kohem, Carla Gonçalves Saad, Antônio Carlos Ximenes, Célio Roberto Gonçalves, Washington Alves Bianchi, Eduardo de Souza Meirelles, Mauro Waldemar Keiserman, Adriano Chiereghin, Cristiano Barbosa Campanholo, André Marun Lyrio, Cláudia Goldenstein Schainberg, Lenise Brandao Pieruccetti…
    Citation: Advances in Rheumatology 2021 61:4
    Content type: Position article and guidelines Published on:

  14. Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pand...

    Authors: Edgard Torres dos Reis Neto, Adriana Maria Kakehasi, Marcelo de Medeiros Pinheiro, Gilda Aparecida Ferreira, Cláudia Diniz Lopes Marques, Licia Maria Henrique da Mota, Eduardo dos Santos Paiva, Gecilmara Cristina Salviato Pileggi, Emília Inoue Sato, Ana Paula Monteiro Gomides Reis, Ricardo Machado Xavier and José Roberto Provenza
    Citation: Advances in Rheumatology 2020 60:32
    Content type: Position article and guidelines Published on:

  15. The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing rece...

    Authors: Gustavo Guimarães Moreira Balbi, Marcelo de Souza Pacheco, Odirlei Andre Monticielo, Andreas Funke, Adriana Danowski, Mittermayer Barreto Santiago, Henrique Luiz Staub, Jozelia Rêgo and Danieli Castro Oliveira de Andrade
    Citation: Advances in Rheumatology 2020 60:29
    Content type: Position article and guidelines Published on:

  16. Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondylo...

    Authors: Gustavo Gomes Resende, Eduardo de Souza Meirelles, Cláudia Diniz Lopes Marques, Adriano Chiereghin, Andre Marun Lyrio, Antônio Carlos Ximenes, Carla Gonçalves Saad, Célio Roberto Gonçalves, Charles Lubianca Kohem, Cláudia Goldenstein Schainberg, Cristiano Barbosa Campanholo, Júlio Silvio de Sousa Bueno Filho, Lenise Brandao Pieruccetti, Mauro Waldemar Keiserman, Michel Alexandre Yazbek, Penelope Esther Palominos…
    Citation: Advances in Rheumatology 2020 60:19
    Content type: Position article and guidelines Published on:

  17. Primary Sjögren’s syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is c...

    Authors: Virginia Fernandes Moça Trevisani, Sandra Gofinet Pasoto, Marilena Leal Mesquita Silvestre Fernandes, Maria Lúcia Lemos Lopes, Sonia Cristina de Magalhães Souza Fialho, Aysa César Pinheiro, Laura Caldas dos Santos, Simone Appenzeller, Tania Fidelix, Sandra Lúcia Euzébio Ribeiro, Danielle Christinne Soares Egypto de Brito, Tatiana Libório, Maria Carmen Lopes Ferreira Silva Santos, Leandro Tanure, Juliana D Agostino Gennari, Vinicius Tassoni Civile…
    Citation: Advances in Rheumatology 2019 59:58
    Content type: Position article and guidelines Published on:

  18. This research is recommended by the Myopathy Committee of the Brazilian Society of Rheumatology for the investigation and diagnosis of systemic autoimmune myopathies.

    Authors: Fernando Henrique Carlos de Souza, Daniel Brito de Araújo, Verônica Silva Vilela, Ricardo Santos Simões, Wanderley Marques Bernardo, Thais Amanda Frank, Bernardo Matos da Cunha and Samuel Katsuyuki Shinjo
    Citation: Advances in Rheumatology 2019 59:42
    Content type: Position article and guidelines Published on:

  19. The V Brazilian Consensus for determination of autoantibodies against cellular constituents on HEp-2 cells, held in Brasilia (DF, Brazil) on August 27, 2016, discussed the harmonization between the Brazilian C...

    Authors: Wilson de Melo Cruvinel, Luis Eduardo Coelho Andrade, Carlos Alberto von Mühlen, Alessandra Dellavance, Antônio Carlos Ximenes, Carlos David Bichara, Cleonice Bueno, Cristóvão Luis Pitangueira Mangueira, Eloísa Bonfá, Fabiano de Almeida Brito, Fernanda Bull Flumian, Glaucielen Gomes da Silva, Jozelia Rêgo, Lisiane Maria Ericoni dos Anjos, Natasha Slhessarenko, Sandra Gofinet Pasoto…
    Citation: Advances in Rheumatology 2019 59:28
    Content type: Position article and guidelines Published on:

    The Correction to this article has been published in Advances in Rheumatology 2020 60:6

  20. In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent Y...

    Authors: Gecilmara Salviato Pileggi, Licia Maria Henrique Da Mota, Adriana Maria Kakehasi, Alexandre Wagner De Souza, Aline Rocha, Ana Karla Guedes de Melo, Caroline Araujo M. da Fonte, Cecilia Bortoletto, Claiton Viegas Brenol, Claudia Diniz Lopes Marques, Cyrla Zaltman, Eduardo Ferreira Borba, Enio Ribeiro Reis, Eutilia Andrade Medeiros Freire, Evandro Mendes Klumb, Georges Basile Christopoulos…
    Citation: Advances in Rheumatology 2019 59:17
    Content type: Position article and guidelines Published on:

  21. Recommendations of the Myopathy Committee of the Brazilian Society of Rheumatology for the management and therapy of systemic autoimmune myopathies (SAM).

    Authors: Fernando Henrique Carlos de Souza, Daniel Brito de Araújo, Verônica Silva Vilela, Mailze Campos Bezerra, Ricardo Santos Simões, Wanderley Marques Bernardo, Renata Miossi, Bernardo Matos da Cunha and Samuel Katsuyuki Shinjo
    Citation: Advances in Rheumatology 2019 59:6
    Content type: Position article and guidelines Published on:

  22. Nailfold capillaroscopy (NFC) is a reproducible, simple, low-cost, and safe imaging technique used for morphological analysis of nail bed capillaries. It is considered to be extremely useful for the investigat...

    Authors: Cristiane Kayser, Markus Bredemeier, Maria Teresa Caleiro, Karina Capobianco, Tatiana Melo Fernandes, Sheila Márcia de Araújo Fontenele, Eutilia Freire, Lilian Lonzetti, Renata Miossi, Juliana Sekiyama and Carolina de Souza Müller
    Citation: Advances in Rheumatology 2019 59:5
    Content type: Position article and guidelines Published on:

  23. The objective of this document is to provide a comprehensive update of the recommendations of Brazilian Society of Rheumatology on drug treatment of rheumatoid arthritis (RA), based on a systematic literature ...

    Authors: Licia Maria Henrique da Mota, Adriana Maria Kakehasi, Ana Paula Monteiro Gomides, Angela Luzia Branco Pinto Duarte, Bóris Afonso Cruz, Claiton Viegas Brenol, Cleandro Pires de Albuquerque, Geraldo da Rocha Castelar Pinheiro, Ieda Maria Magalhães Laurindo, Ivanio Alves Pereira, Manoel Barros Bertolo, Mariana Peixoto Guimarães Ubirajara Silva de Souza, Max Vitor Carioca de Freitas, Paulo Louzada-Júnior, Ricardo Machado Xavier and Rina Dalva Neubarth Giorgi
    Citation: Advances in Rheumatology 2018 58:2
    Content type: Position article and guidelines Published on: