[Practice guideline 'Diagnosis and treatment of rheumatoid arthritis'].
Treatment early in the course of the disease, along with early diagnosis, has a positive influence on clinical outcome in patients with rheumatoid arthritis (RA). Therapeutic strategies, including the use of 'disease-modifying antirheumatic drug' (DMARD) combinations, have proved effective, with relatively few side effects. New insights into the pathophysiology of RA have lead to the development of novel therapeutic agents that have been demonstrated to be highly effective. Patients should be monitored intensively with respect to the effect of therapy on reduction of disease activity, followed by modification of therapeutic strategy in the case of a suboptimal treatment response. Various non-pharmacological interventions, such as exercise therapy and patient education, are available to help patients to cope with the consequences of the disease. Optimizing treatment of RA by means of this approach will help to realize the goal of current therapy: to achieve and sustain remission and, thereby, an optimal functional level.
Schipper
Lydia G
LG
Universitair Medisch Centrum St Radboud, afdeling Reumatologie, Nijmegen, The Netherlands.
Hoekstra
Monique
M
Vliet Vlieland
Thea P M
TP
Jansen
Tim L
TL
Lems
Willem F
WF
van Riel
Piet  L C M
P
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy*; D018450:Disease Progression; D005081:Exercise Therapy; D006801:Humans; D009426:Netherlands; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D012074:Remission Induction; D012219:Rheumatology / Q000592:standards*; D016896:Treatment Outcome
D018501:Antirheumatic Agents