4 Technologies such as ultrasound have been increasingly used for diagnosis and monitoring of synovitis where it is unclear from clinical examination.
2 The management of rheumatoid arthritis has evolved in the nine years since the previous NICE guideline on rheumatoid arthritis was published, with greater emphasis on a treat-to-target strategy rather than specific drug regimens, 3 and debate about the merit of initiating treatment with combination drug therapy.
#RHEUMATOID ARTHRITIS DIAGNOSIS CRITERIA 2013 UPDATE#
This article summarises the update of the National Institute for Health and Care Excellence (NICE) guideline for the diagnosis and management of rheumatoid arthritis in adults. Fast and accurate referral to rheumatology services is important to achieve early remission and prevent or reduce disability. The early signs of rheumatoid arthritis are often encountered in primary care, where people present with joint pain and swelling. People tend to develop rheumatoid arthritis between 40 and 60 years of age, although it can arise at any age. It affects roughly three times as many women as men. About 1% of the UK population have rheumatoid arthritis, and approximately 15% of these people have severe disease. Rheumatoid arthritis is a chronic, disabling autoimmune disease characterised by synovitis of small and large joints causing swelling, stiffness, pain, and progressive joint destruction. Offer the lowest effective dose of NSAID for the shortest possible time, with a proton pump inhibitor and review risk factors for adverse events regularly
To begin treatment, use one disease modifying anti-rheumatic drug (DMARD) and increase the dose, before adding another DMARD, if neededĬonsider short term bridging therapy with glucocorticoids when starting a new conventional synthetic DMARDĬonsider oral non-steroidal anti-inflammatory drugs (NSAIDs) for uncontrolled pain or stiffness Neogi T, Aletaha D, Silman AJ et al (2010) The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Phase 2 methodological report.
Aim for remission or low disease activity as the target for treatment Majithia V, Geraci SA (2007) Rheumatoid arthritis: diagnosis and management.
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