EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update
An erratum to this article was published (Ann Rheum Dis, Mar 2023 ↗)
Methodological detailsEULAR update, international task force, three systematic literature research activities, predefined voting process
- EULAR update
- International task force
- Three systematic literature research activities
- Predefined voting process
Recommendations
As issued by the authors
Initially, methotrexate (MTX) plus glucocorticoids (GCs) is recommended
On insufficient response within 3-6 months, treatment should be based on stratification according to risk factors
With poor prognostic factors (presence of autoantibodies, high disease activity, early erosions or failure of two csDMARDs), any bDMARD should be added to the csDMARD; after careful consideration of risks of major cardiovascular events (MACEs), malignancies and/or thromboembolic events tsDMARDs may also be considered in this phase
If the first bDMARD (or tsDMARD) fails, any other bDMARD (from another or the same class) or tsDMARD (considering risks) is recommended
With sustained remission, disease-modifying antirheumatic drugs (DMARDs) may be tapered but should not be stopped
Original publication
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