-
The primary target for treatment of rheumatoid arthritis should be a state of clinical remission. -
Clinical remission is defined as the absence of signs and symptoms of significant inflammatory disease activity. -
While remission should be a clear target, based on available evidence, low disease activity may be an acceptable alternative therapeutic goal, particularly in established longstanding disease. -
Until the desired treatment target is reached, drug therapy should be adjusted at least every 3 months. -
Measures of disease activity must be obtained and documented regularly, as frequently as monthly for patients with high/moderate disease activity or less frequently (such as every 3 to 6 months) for patients in sustained low disease activity or remission. -
The use of validated composite measures of disease activity, which include joint assessments, is needed in routine clinical practice to guide treatment decisions. -
Structural changes and functional impairment should be considered when making clinical decisions, in addition to assessing composite measures of disease activity. -
The desired treatment target should be maintained throughout the remaining course of the disease. -
The choice of the (composite) measure of disease activity and the level of the target value may be influenced by consideration of comorbidities, patient factors, and drug-related risks. -
The patient has to be appropriately informed about the treatment target and the strategy planned to reach this target under the supervision of the rheumatologist.
|