Rheumatoid Arthritis
Key Points
Key Points
- Initiating methotrexate early for the treatment of patients with moderate to high disease activity.
- Adjusting methotrexate to achieve maximal benefit prior to adding additional disease modifying anti-rheumatic drugs.
- Minimizing the use of glucocorticoids whenever possible.
- Implementing a treat to target (TTT) strategy.
Treatment
Treatment
...ng Principles RA requires early evaluation, di...
...Initiation...
...of treatment in DMARD-naive patients with moderat...
...loroquine. (Strong, Very Low)578...
sulfasalazine. (Strong, Lo...
bDMARD (Strong, Very Lo...
...MARD monotherapy. (Strong, Mode...
...methotrexate plus a non-TNF inhibitor bDMARD (S...
...(Strong, Very Low)c The direction of the benef...
...(Conditional, Low)578...
...csDMARD therapyc (Conditional, Modera...
...of methotrexate plus a TNF inhibitor...
...ion of a csDMARD without short-term (...
...tiation of a csDMARD without longer-term (...
...ation of treatment in DMARD-naive patients wit...
...uine is conditionally recommended over other csD...
...ine is conditionally recommended over...
...otrexate is conditionally recommende...
...of treatment in csDMARD treated, but methotr...
...onditional, Moderate)578...
...RDc,e. (Conditional, Very Low)c The direction of t...
...ethotrexate Administra...
...tients initiating methotrexate, or...
...t least 15 mg within four to six weeks...
...weekly dose of less than 15 mg.a (,...
...t tolerating oral methotrexate, spli...
...atients taking oral methotrexate wh...
...eatment Modification
...o have not been previously treated with bDMARD...
...who have had an inadequate response t...
...itial treatment goal of low disease ac...
...taking maximally tolerated doses of...
...patients taking a bDMARD or tsDMARD who...
...king glucocorticoids to remain at target...
...patients taking DMARDs who are not at target,...
...ring DMARD...
...of all DMARDs at their current dose is conditiona...
...tion is conditionally recommended over gr...
...scontinuation is conditionally recommended ove...
...ing triple therapy who wish to discontin...
...to discontinue a DMARD, gradual discontinuation o...
...pecific Patient Popul...
...ubcutaneous Nod...
...or patients with subcutaneous nodules who ha...
...ents taking methotrexate with prog...
...monary Disease...
...patients with clinically diagnosed mild and stabl...
...rt Failur...
...ents with NYHA class III or IV heart f...
For patients taking a TNF inhibitor who...
...hoproliferative Dis...
...th a previous lymphoproliferative disorder for wh...
Hepatitis B
...ents initiating rituximab who are hepatitis B cor...
...initiating any bDMARD or tsDMARD who are hepatit...
...itiating a bDMARD other than ritux...
Nonalcoholic Fatty Liver Disease (NAFLD...
...MARD naïve patients with NAFLD, normal liver e...
...pogammaglobulinemia without Infectio...
...tting of persistent hypogammaglobulin...
...s Serious Infection...
For patients with a serious infection within...
...atients with a serious infection within...
...us Mycobacterial (NTM) Lung diseas...
...patients with NTM lung disease, us...
...th NTM lung disease, who have moderate to high dis...
...with NTM lung disease, who have moderate...
...7. DMARDsHaving trouble viewing table...
...heumatoid Arthritis Pharmacologic Mana...