The treatment of Rheumatoid Arthritis (RA) is now not limited to a few DMARDs (non-biologics) alone

1. Tet n o er R
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2. Apollo Medicine 2012 December
Algorithms
Volume 9, Number 4; pp. 345e346
Treatment of early RA
Sundeep Upadhyaya*
ABSTRACT
The treatment of Rheumatoid Arthritis (RA) is now not limited to a few DMARDs (non-biologics) alone; there are
a variety of biological targets that can be modified with the use of biological agents (Biologic-DMARDs). Another
especially significant change is the policy of treating early and "treating to target" based on disease activity scores
(CDAI, DAS28 etc.). There is also more use of “triple DMARDs” and corticosteroids. Moreover, the EULAR-ACR 2010
RA diagnostic criteria can identify patients with inflammatory arthritis as fulfilling criteria for RA even at 6 weeks of
disease duration. The ACR- 2012 modification of the 2008 guidelines for management of RA (Biologic & Non Biologic
Management)1 serves as a guide to the management of RA both in the Indian setting and for other developing
countries. This algorithm borrows from this and also refers to the Indian Rheumatology Association consensus
statement for the management of RA.2
REFERENCES arthritis. Arthritis Care Res (Hoboken). 2012 May;
64(5):625e639.
1. Singh JA, Furst DE, Bharat A, et al. 2010 update of the 2. Misra R, Sharma BL, Gupta R et al. Indian Rheuma-
2008 American College of Rheumatology recommenda- tology Association consensus statement on the manage-
tions for the use of disease-modifying antirheumatic ment of adults with rheumatoid arthritis. Indian J
drugs and biologic agents in the treatment of rheumatoid Rheumatol 2008;39:S1eS6.
Senior Consultant, Rheumatology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
*
Tel.: þ91 9818359408, email: sundeepupadhyaya@hotmail.com
Received: 27.9.2012; Accepted: 29.9.2012; Available online 13.10.2012
http://dx.doi.org/10.1016/j.apme.2012.09.005

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