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
Treatm...
...nciples RA requires early evaluati...
...ARD Initiatio...
...of treatment in DMARD-naive patient...
...ychloroquine. (Strong, Very Low)578...
...azine. (Strong, Low)578...
...DMARD (Strong, Very Low...
...therapy. (Strong, Moderate)578...
...ation of methotrexate plus a non-T...
...Strong, Very Low)c The direction of the beneficia...
...flunomide (Conditional, Lo...
...l or triple csDMARD therapyc (Conditio...
...methotrexate plus a TNF inhibitorc. (Conditio...
...f a csDMARD without short-term (...
...on of a csDMARD without longer-term (≥3 months)...
...f treatment in DMARD-naive patients w...
...ne is conditionally recommended over other csDM...
...conditionally recommended over methotrexat...
...otrexate is conditionally recommended over leflu...
...reatment in csDMARD treated, but methotrexat...
...nditional, Moderate)578...
...e. (Conditional, Very Low)c The direction of the...
...xate Administration...
...initiating methotrexate, oral methotrexate is co...
...st 15 mg within four to six weeks is co...
...kly dose of less than 15 mg.a (, Very Low)578
For patients not tolerating oral met...
...or patients taking oral methotrexate who are not...
...ent Modification...
...ho have not been previously treated with bDMARDs...
...have had an inadequate response to bDM...
...ial treatment goal of low disease activity is...
...ts taking maximally tolerated doses o...
...patients taking a bDMARD or tsDMARD who...
...taking glucocorticoids to remain at target...
...atients taking DMARDs who are not...
...ring DMARDs...
...tinuation of all DMARDs at their current dose...
Dose reduction is conditionally recomme...
...inuation is conditionally recommended over a...
...patients taking triple therapy who...
who wish to discontinue a DMARD, gradual disc...
...ific Patient Populatio...
Subcutaneous Nodul...
...s with subcutaneous nodules who have...
...king methotrexate with progressive subcutaneo...
...monary Diseas...
...ents with clinically diagnosed mild and sta...
...t Failure...
...patients with NYHA class III or IV heart...
...r patients taking a TNF inhibitor who...
...phoproliferative Dis...
...with a previous lymphoproliferative...
Hepatitis...
...ents initiating rituximab who are...
...nts initiating any bDMARD or tsDMARD...
...ents initiating a bDMARD other than...
...Fatty Liver Disease (NAFLD)...
For DMARD naïve patients with NAFLD...
...stent Hypogammaglobulinemia without Infection...
...tting of persistent hypogammaglobuli...
...Serious Infection...
For patients with a serious infection within th...
...ts with a serious infection within the previ...
...ntuberculous Mycobacterial (NTM) Lung disea...
...patients with NTM lung disease, use of the lowes...
...h NTM lung disease, who have moderate to high dis...
...s with NTM lung disease, who have moderat...
...RDsHaving trouble viewing table? Expa...
...Rheumatoid Arthritis Pharmacologic Man...