Updated ACR guidelines on the management of RA are expected to be released in fall 2020. According to current ACR guidelines from 2015, patients with established RA who have moderate or high disease activity and who have never taken a DMARD should receive DMARD monotherapy (methotrexate preferred) over tofacitinib. For patients with established RA who have moderate or high disease activity despite use of a DMARD, TNF inhibitor, or non-TNF biologic therapy, treatment with short-term, low-dose glucocorticoids is recommended. Live attenuated herpes zoster vaccination is not recommended in patients with RA who are taking TNF inhibitor biologics or non-TNF biologics. For patients with symptomatic early RA who have moderate or high disease activity and have never taken a DMARD, the 2015 ACR guidelines recommend DMARD monotherapy over both double and triple therapy.
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Cite this: Herbert S. Diamond. Fast Five Quiz: Arthritis - Medscape - Jul 28, 2020.