New RA guideline emphasizes maximizing methotrexate and biologics, minimizing steroids

November 06, 2020

ATLANTA -- The American College of Rheumatology (ACR) will preview its 2020 Guideline for the Management of Rheumatoid Arthritis (RA) at ACR Convergence, the ACR's annual meeting. The comprehensive, clinical recommendations for pharmacologic treatment of RA includes important updates to the previous guideline released in 2015.

Rheumatoid arthritis (RA) is the most common type of chronic inflammatory arthritis. In RA, the immune system, the body's defense system against disease and injury, is not working properly. RA commonly causes pain and swelling in the wrist and small joints of the hand and feet but can affect almost all joints. Treatments for RA can stop joint pain and swelling and may also prevent joint damage. Early treatment will give patients with RA better long-term results.

While these recommendations focus solely on drug treatments for RA, future ACR guidelines will include non-drug therapies and vaccines. The new guideline was developed by a broad range of stakeholders in RA treatment, including rheumatologists, methodologists, and patients living with the disease.

"Patients with RA were involved at every step of the process and these recommendations truly reflect their perspectives. By including their personal experiences with different therapies, including their effectiveness, ease of use and side effects, the recommendations reflect the ACR's goal of shared decision making between the rheumatologist and patient," says Principal Investigator Liana Fraenkel, MD, MPH, professor adjunct in the Division of Rheumatology, Allergy and Immunology at Yale University School of Medicine. Fraenkel will discuss the recommendations at a press conference on Monday, Nov. 9 at 8:30 a.m. (ET).

Recommendations emphasize: New recommendations include: RA is a complex disease that may affect patients in different ways, so rheumatologists often need to individualize management approaches and decision making. Also, new pharmacologic agents are being approved for RA at a rapid pace, expanding the treatment options for this disease.

"Despite the many treatment recommendations included in this guideline, there are a number of remaining questions to address in more frequent, future updates. This guideline is a living document. As more therapies for RA emerge, we will modify what we recommend now," she says.

Recommendations were developed by panelists using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to assess available evidence from current scientific literature.

The manuscript, containing the full list of recommendations and supporting evidence, is currently under review and is anticipated to be simultaneously published in Arthritis Care & Research and Arthritis & Rheumatology by fall 2020, pending completion of peer review.
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About ACR Convergence

ACR Convergence, the ACR's annual meeting, is where rheumatology meets to collaborate, celebrate, congregate, and learn. Join ACR for an all-encompassing experience designed for the entire rheumatology community. ACR Convergence is not just another meeting - it's where inspiration and opportunity unite to create an unmatched educational experience. For more information about the meeting, visit https://www.rheumatology.org/Annual-Meeting, or join the conversation on Twitter by following the official hashtag (#ACR20).

About the American College of Rheumatology

The American College of Rheumatology (ACR) is an international medical society representing over 7,700 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases.

American College of Rheumatology

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