Treatment of rheumatoid arthritis

Abstract

The goals of therapy in rheumatoid arthritis have been defined as’ symptom control, the reduction of joint damage and disability, and maintenance or improvement of quality of life’ (SIGN 2000). In early arthritis, major goals include:

• Control of symptoms and signs of disease, maintenance of function; and fostering of self-efficacy [British Society for Rheumatology guidelines (BSR) (Luqmani et al. 2006)].

• Control of components of disease activity, such as DAS-28 and CRP [NICE guidelines (NICE 2009)]. Both the BSR and NICE guidelines suggest that each patient should be engaged in an individualised care plan that includes an objective measure of disease activity. The ultimate aim of management should be remission of disease (Combe et al. 2007, Luqmani et al. 2006), and, to this end, there is increasing interest in a ‘treatment-to-target’ approach.