Patients with signs and symptoms of early rheumatoid arthritis (RA) should be referred to a multidisciplinary rheumatology clinic. The ACR-EULAR criteria help in identification of patients with risk for erosive RA. Treatment should aim at early remission. Start with the combination of methotrexate, hydroxychloroquine, sulfasalazine, and low-dose glucocorticoid is recommended if no contraindications. Methotrexate has better bioavailability as injection. Glucocorticoids are injected to active joints. Patient education with shared decision is essential. Exercise training is recommended. If treatment target is not achieved by the DMARD combination, a biological drug is added.
Kari Puolakka (Chair)