Rheumatoid arthritis

ACR: New RA guidelines

Tuesday, 17 Nov 2015

The American College of Rheumatology has released a new set of recommendations for the treatment of rheumatoid arthritis.

The guidelines update those released in 2012 and address what the guideline development team considered were the most common clinical scenarios physicians face when treating RA and helping patients manage the condition.

Included recommendations address:

  • The use of DMARDs, biologics, tofacitinib and glucocorticoids in patients with early RA (less than six months) and established RA (six months or more),
  • Recommendations on using a treat-to-target approach, tapering and discontinuing medications;
  • The use of biologics and DMARDs in high-risk RA patients with comorbidities (i.e., hepatitis, congestive heart failure, malignancy and serious infections);
  • The use of vaccines in patients starting/receiving DMARDs or biologics;
  • Screening for tuberculosis in patients starting/receiving biologics or tofacitinib; and
  • Laboratory monitoring for traditional DMARDs.

The new guideline was developed using the GRADE methodology [Grading of Recommendations Assessment, Development and Evaluation] which includes a clear specification of patient groups, interventions, competing treatment alternatives and outcomes; grading the quality of the evidence used; and basing recommendation strength on evidence quality, balance of benefits and harms, patient preference of treatment options, as well as clinical experience and expertise.

You can read the executive summary here. 

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