![]() ![]() Use DMARD monotherapy ( Methotrexate preferred) over tofacitinib.If the RA disease activity is moderate or high, in patients who have never taken a DMARD.If the rheumatoid arthritis disease activity is low, in patients who have never taken a DMARD, DMARD monotherapy ( Methotrexate preferred ) should be used rather than a TNF inhibitor.Physicians must use a treat to target strategy rather than a non-targeted approach regardless of the disease activity level (Low).Recommendations for patients with established RA Treatment algorithm for treatment-naive patients If disease flares, add short term glucocorticoids at the lowest possible dose and for the shortest possible time.If the disease activity remains moderate or high despite DMARD or biologic therapies, add low dose glucocorticoids.Use a TNF inhibitor + methotrexate over tofacitinib + methotrexate.Use TNF inhibitor monotherapy over tofacitinib monotherapy. ![]() If the disease activity remains moderate or high despite DMARDs:.If the disease activity remains high despite DMARDs monotherapy (with or without glucocorticoids), use combination DMARDs, or TNF inhibitors or a non-TNF biologics (all choices with or without methotrexate) rather than continuing DMARD monotherapy.Use DMARD monotherapy over triple therapy.Use DMARD monotherapy over double therapy.If the RA disease activity is moderate or high, in patients who have never taken DMARD therapy:.Use DMARD monotherapy ( Methotrexate preferred) over triple therapy.Use DMARD monotherapy ( Methotrexate preferred) over double therapy.If the rheumatoid arthritis disease activity is low, in patients who have never taken DMARD therapy.Physicians must use a treat to target strategy rather than a non-targeted approach, regardless of the disease activity level (Low).Recommendations for patients with symptomatic early RA Simplified Disease Activity Index (SDAI) (range 0–86.0) Remission: 2.8 – 10.0 Moderate activity: > 10.0–22.0 High activity: > 22ĭisease Activity Score (DAS) 28 erythrocyte sedimentation rate (ESR) (range 0–9.4) Remission: 0–1.0Low activity: > 1.0–2.0Moderate activity: > 2.0 –4.0High activity: > 4.0 – 10Ĭlinical Disease Activity Index (CDAI) (range 0–76.0) Routine Assessment of Patient Index Data 3 (RAPID3) (range 0–10) Patient Activity Scale (PAS) or PASII (range 0–10) ![]() Instruments that measure RA disease activity and define remission Revision of the 2010 ACR/EULAR criteria for diagnosing Rheumatoid arthritis.
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