title: The use of conventional disease-modifying anti-rheumatic drugs in established RA.
abstract: Conventional disease-modifying anti-rheumatic drugs (DMARDs) are the main tool to treat any form of rheumatoid arthritis (RA). Over the years, treatment strategies and use of DMARDs have changed. 'Tight control' and 'treat-to-target' are now the present paradigms. Combining DMARDs and adapting their dosages to obtain the best (clinical) result in individual RA patients with the least amount of medication has been and is studied worldwide. Literature results are mainly on early RA however, and they do not necessarily also apply to patients with established RA. Methotrexate (MTX) is the key conventional DMARD also for the treatment of established RA, and MTX often has to be combined with other DMARDs to reach low disease activity. However, there is lack of data on combination DMARD strategies and on how to treat best individual patients with established RA. In this review, we address these uncertainties and give an overview of available data.
authors.affiliation: Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, The Netherlands. mjurgens@umcutrecht.nl
authors.forename: M S
authors.initials: MS
authors.lastname: Jurgens
authors.forename: J W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: J W J
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D008727:Methotrexate