Combination DMARD therapy
- introducing and withdrawing DMARDs (1)
- if newly diagnosed active rheumatoid arthirtis (RA)
- offer a combination of DMARDs (including methotrexate and at least one other DMARD, plus short-term glucocorticoids) as first-line treatment as soon as possible, ideally within 3 months of the onset of persistent symptoms
- if newly diagnosed RA for whom combination DMARD therapy is not appropriate
- start DMARD monotherapy, placing greater emphasis on fast escalation to a clinically effective dose rather than on the choice of DMARD
- if newly diagnosed active rheumatoid arthirtis (RA)
Accepted combinations of DMARDS include:
- methotrexate with any of the following:
- cyclosporin A
- infliximab
- etanercept
- leflunomide
- sulfasalazine and hydroxychloroquine
- sulfasalazine, hydroxychloroquine and prednisolone
Reference:
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