5
DMARD-Naïve
Early RA
Low Disease
Activity
Moderate or
High Disease
Activity
Moderate or
High Disease
Activity
a, b
Combination Traditional DMARDs
a, b
or
TNF Inhibitor +/- MTX
a, b
or
Non-TNF Biologic +/- MTX
a, b
Moderate or
High Disease
Activity
See Established RA
algorithm
Treat to
Target
c
a
Also consider using short-term glucocorticoids (defined as <3 months treatment) for RA disease
flares. Glucocorticoids should be used at the lowest possible dose and for the shortest possible
duration to provide the best benefit-risk ratio for the patient.
b
Consider adding low-dose glucocorticoids (≤10 mg/day of prednisone or equivalent) in patients with
moderate or high RA disease activity when starting DMARDs and in patients with DMARD failure or
biologic failure.
c
Treatment target should ideally be low disease activity or remission.
Figure 1. Early Rheumatoid Arthritis
DMARD
Monotherapy
a
DMARD
Monotherapy
a
