5
Table 3. Oligoarthritis
Recommendations Certainty of Evidence
A trial of consistent NSAIDs is conditionally recommended
as part of initial therapy.
Very low
Intra-articular glucocorticoids (IAGCs) are strongly
recommended as part of initial therapy.
Very low
Triamcinolone hexacetonide (THA) is strongly
recommended as the preferred agent.
Low
Oral glucocorticoids are conditionally recommended against
as part of initial therapy.
Very low
Conventional synthetic DMARDs are strongly
recommended if there is an inadequate response to scheduled
NSAIDs and/or IAGCs.
Low (MTX)
Very low
(LEF, SSZ, HCQ)
Methotrexate (MTX) is conditionally recommended as a
preferred agent over leflunomide (LEF), sulfasalazine (SSZ)
and hydroxychloroquine (HCQ) (in that order).
Biologic DMARDs are strongly recommended if there is
inadequate response to or intolerance of NSAIDs and/or
IAGCs and at least one conventional synthetic DMARD.
Very low
ere is no preferred biologic DMARD.
Consideration of risk factors for poor outcome (e.g.,
involvement of ankle, wrist, hip and/or temporomandibular
joint arthritis (TMJ), presence of erosive disease, delay in
diagnosis, elevated inflammatory markers, symmetric disease)
is conditionally recommended to guide treatment decisions.
Very low
Use of validated disease activity measures is conditionally
recommended to guide treatment decisions, especially to
facilitate treat-to-target approaches.
Very low
