Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the European League Against Rheumatism (EULAR).

Management of Rheumatoid Arthritis with Synthetic and Biologic Disease-Modifying Antirheumatic Drugs

European League Against Rheumatism (EULAR)

Publication Date: Mar 13, 2026

Page Last Updated: May 6, 2026

Recommendation Grading

Document Title: Management of Rheumatoid Arthritis with Synthetic and Biologic Disease-Modifying Antirheumatic Drugs

Source Citation: Smolen, Josef S et al. “EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update.” Annals of the rheumatic diseases, S0003-4967(26)00075-0. 12 Mar. 2026, doi:10.1016/j.ard.2026.01.023

Document Objectives: This study aims to provide an update of the European Alliance of Associations for Rheumatology (EULAR) rheumatoid arthritis (RA) management recommendations addressing the most recent insights. These updated EULAR recommendations provide consensus on RA management based on currently available evidence regarding efficacy, safety, and cost.

LOE	Meaning
1a	systematic review of RCTs
1b	individual RCT
2a	systematic review of cohort studies
2b	individual cohort study (and low-quality RCT)
3a	systematic review of case–control studies
3b	individual case–control study
4	case series and poor-quality cohort and case–control studies
5	expert opinion without explicit critical appraisal, or based on physiology, bench research or ‘first principles’

SOR	Meaning
A	consistent level 1 studies
B	consistent level 2 or 3 studies, or extrapolations from level 1 studies
C	level 4 studies or extrapolations from level 2 or 3 studies
D	level 5 evidence or troublingly inconsistent or inconclusive studies of any level