Treatment Guidelines in Rheumatoid Arthritis—Optimizing the Best of Both Worlds

Purpose of review Rheumatoid arthritis (RA) leads to significant joint damage and systemic complications. Available treatment options for RA has made it possible to achieve a good control over disease activity and improve patient outcomes. In this review, we discuss management guidelines for RA and their practical application by discussing clinical scenarios commonly encountered in rheumatology practice. Recent findings European League Against Rheumatism recently updated treatment recommendations for management of RA. The general fundamentals of these recommendations are similar to those of the 2015 American College of Rheumatology guidelines for the treatment of RA but with some key distinctions. We discuss three RA cases to illustrate key aspects of treatment guidelines. New data show increased cardiovascular risk in patients with RA that is possibly related to associated systemic inflammation. Summary While several questions about RA remain unanswered, the clinical outcomes have improved in recent years. A strategic approach to manage RA is recommended which involves early diagnosis and treatment and escalating treatments to achieve a therapeutic target. In addition to treating RA disease activity, management of comorbid conditions is imperative to prevent long-term systemic damage.