APLAR Rheumatoid Arthritis Management Guideline Summary - Guideline Central
Summary of Recommendations
Document Overview

Rheumatoid Arthritis Management

Asia-Pacific League of Associations for Rheumatology


Publication Date: Jun 26, 2026

Page Last Updated: Jul 15, 2026

Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-Based Recommendations

Implications for:Strong Recommendation (S)Conditional Recommendation (C)
PatientsMost individuals in this situation would want the recommended course of action, and only a small proportion would not.The majority of individuals in this situation would want the suggested course of action, but many would not.
CliniciansMost individuals should receive the intervention. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.
PolicyThe recommendation can be adopted as policy in most situations.Policymaking will require substantial debate and involvement of various stakeholders.
Certainty in the Evidence
HighHLowL
ModerateMVery LowVL

Source: Grading of Recommendations Assessment, Development and Evaluation Working Group (Schunemann HJ et al. Am J Respir Crit Care Med. 2006;174:605-14. Guyatt GH et al. BMJ 2008;336:924-6).

Document Overview

Document Title
Rheumatoid Arthritis Management
Authoring Society

Asia-Pacific League of Associations for Rheumatology

Document Publication Date
Jun 26, 2026
Page Last Reviewed/Updated
Jul 15, 2026
Document Type
Guideline
Country of Publication
United States
Full Text Freely Available
Yes
Full Text Guideline
onlinelibrary.wiley.com/doi/10.1111/1756-185x.70752
Source Citation
Yamaoka, Kunihiro et al. “2024 Update of the Asia-Pacific League of Associations for Rheumatology (APLAR) Recommendations for Rheumatoid Arthritis Management.” International journal of rheumatic diseases vol. 29,7 (2026): e70752. doi:10.1111/1756-185x.70752

Document Scope, Criteria, and Use Cases

Document Objectives
The aim of this document is to update the Asia-Pacific League of Associations for Rheumatology (APLAR) treatment recommendations for rheumatoid arthritis (RA) by incorporating new evidence and reassessing the validity of previous guidance: METHODS: A literature search for relevant publications from January 2018 to August 2023 was conducted, supplemented by earlier studies where relevant. Recommendations were formulated based on this evidence and refined through a modified-Delphi process during a series of online meetings. The quality of evidence and strength of recommendations were assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. This update comprises 14 statements that achieved consensus during the meetings. Topics covered include measurement of disease activity and treatment response, the use of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), the use of targeted therapies, vaccination and screening for infections and the use of DMARDs during pregnancy. The recommendations address the selection of disease activity scores, initiation and intensification of therapy using csDMARDs and targeted therapies, and management of RA in patients at risk of reactivation of infectious diseases. These recommendations are discussed in the context of the clinical landscape encountered in the Asia-Pacific region. These updated recommendations complement previous APLAR guidelines and aim to support best practice management of RA across the Asia-Pacific region. They provide a practical framework for national rheumatology associations to develop local guidelines adapted to their specific needs and clinical practice.
Scope
Management
Diseases/Conditions (MeSH)

D001172 - Arthritis, Rheumatoid

Keywords
rheumatoid arthritis
Inclusion Criteria
Male, Female, Adult, Older Adult
Health Care Settings
Ambulatory
Intended Users
Nurse, Nurse Practitioner, Physician, Physician Assistant
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