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Rheumatoid Arthritis | Current Guidelines | Epidemiology & Principles

Joint damage begins within the first 3 months of disease onset. There is a ‘window of opportunity’ where early aggressive therapy of RA can suppress inflammation before irreversible joint destruction has occurred. Early diagnosis and initiation of DMARD therapy are therefore critical. The 2010 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria are a useful reference Every and each clinicians must aim to achieve remission or LDA in all patients as soon as possible – aiming for 50% improvement in disease activity score, a level of disease activity lower from baseline within 3 months, and target at 6 months. Frequent evaluation is needed (every 1 - 3 months) in patients with active disease, with adjustment of therapy until target is reached, after which time less frequent assessments (3 - 6-monthly) are acceptable.