8
Treatment
Figure 2. Established Rheumatoid Arthritis
2
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 traditional DMARDs and in patients with
DMARD failure or biologic failure.
Low Disease
Activity
Moderate or
High Disease
Activity
DMARD
Monotherapy
a
DMARD
Monotherapy
a
Combination Traditional
DMARDs
a, b
or
TNF Inhibitor +/- MTX
a, b
or
Non-TNF Biologic +/- MTX
a, b
or
Tofacitinib +/- MTX
Treat to
Target
c
Low disease
activity, but
not remission,
continue RA
treatments
d
In remission,
consider tapering
RA treatments
d
Moderate or
High Disease
Activity
DMARD-Naïve
Established RA
Moderate
or High
Disease
Activity
a, b
Continued on next page
