التهاب المفاصل الروماتويدي مع موانع أو عدم تحمل الميثوتريكسات وارتفاع العامل الروماتويدي

References

DOI: 10.1136/ard-2022-223356

1. In patients with a contraindication to MTX (or early intolerance), leflunomide or sulfasalazine should be considered as part of the (first) treatment strategy.
2. Short-term glucocorticoids should be considered when initiating or changing csDMARDs, in different dose regimens and routes of administration, but should be tapered and discontinued as rapidly as clinically feasible.
3. Presence of RF and/or ACPA, especially at high levels.
4. Presence of early erosions.
5. Failure of 2 or more csDMARDs.
6. Treatment should be aimed at reaching a target of sustained remission or low disease activity in every patient.
7. Monitoring should be frequent in active disease (every 1–3 months); if there is no improvement by at most 3 months after the start of treatment or the target has not been reached by 6 months, therapy should be adjusted.