EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update
Methodological detailsinternational task force, 2 systematic literature research activities, voting process
- International task force
- 2 systematic literature research activities
- Voting process
Recommendations
As issued by the authors
Initially, MTX ideally in combination with short-term glucocorticoids (GCs) is recommended
Upon insufficient response after 3 to 6 months, a bDMARD should be added; after careful consideration of risks, including major cardiovascular events (MACEs), malignancies and/or thrombo-embolic events, JAKi may also be considered
If the first bDMARD (or JAKi) fails, any other bDMARD (from another or the same class) or JAKi (considering risks) is recommended
With sustained remission, disease-modifying antirheumatic drugs (DMARDs) may be tapered, but caution is required as stopping often leads to a flare
Original publication
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update. Ann Rheum Dis. Published 13 March 2026. doi:10.
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