Key Points
Integrative Interventions for Rheumatoid Arthritis Guiding Principles:
` Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory condition
that requires early diagnosis, evaluation, and management to achieve
optimal outcomes.
` Rheumatoid arthritis should be treated with disease-modifying anti-
rheumatic drugs and follow a treat-to-target management strategy, as
detailed in the 2021 American College of Rheumatology (ACR) Rheumatoid
Arthritis Pharmacologic Treatment Guidelines.
1
` Persons with chronic diseases, like rheumatoid arthritis, seek many
available therapies to maintain physical function, reduce pain, and improve
their quality of life.
` Treatment decisions should follow a shared decision-making process.
Persons with rheumatoid arthritis present with a variety of manifestations
and experiences.
` Optimum rheumatoid arthritis treatment outcomes are achieved through
interprofessional teams providing expert patient-centered care.
` Recommendations assume no contraindications to listed management
strategies.
` Recommendations pertain to rheumatoid arthritis management.
• Recommendations do not pertain to clinical situations when patients have alternative
indications for listed treatments.
• Other general health benefits may exist for listed treatments.
` Surgical interventions are not included in this guideline because there are
other guideline efforts that address large joint replacement, and small
joint surgeries are not frequently a part of the current management of
rheumatoid arthritis.
` Disease activity and disease activity levels refer to those calculated using
an ACR-endorsed RA disease activity measure.
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1. Fraenkel L, Bathon JM, England BR, St. Clair EW, Arayssi T, Carandang K, et al. 2021 American College
of Rheumatolog y guideline for the treatment of rheumatoid arthritis. Arthritis Care Res 2021;73:924-939.
2. England BR, Tiong BK, Bergman MJ, Curtis JR, Kazi S, Mikuls TR, et al. 2019 Update of the American
College of Rheumatolog y Recommended Rheumatoid Arthritis Disease Activity Measures. Arthritis Care.
2019;71:1540-1555.
