Rheumatoid Arthritis Clinical Practice Guidelines (JCR, 2022)

Guidelines for the management of rheumatoid arthritis were published in March 2022 by the Japan College of Rheumatology (JCR) in Modern Rheumatology.^[1]

Methotrexate (MTX) is recommended in patients with active rheumatoid arthritis (RA).

Folic acid is recommended in RA patients using MTX.

Concomitant use of a TNF inhibitor is recommended in RA patients with moderate or severe disease activity who have had an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs).

Concomitant use of a non-TNF inhibitor is recommended in RA patients with moderate or severe disease activity who have had an inadequate response to csDMARDs.

A non-TNF inhibitor (T-cell selective co-stimulation modulator) and a TNF inhibitor are equally recommended when a biological disease-modifying antirheumatic drug (bDMARD) is used in combination with MTX in RA patients with moderate or severe disease activity who have had an inadequate response to MTX.

A non-TNF inhibitor (IL-6 inhibitor) is recommended when a bDMARD is used without MTX in RA patients with moderate or severe disease activity who are intolerant to MTX or who have had an inadequate response to MTX.

Reference bDMARDs and biosimilars are equally recommended in RA patients with high or moderate disease activity who have had an inadequate response to csDMARDs.

Use of appropriate doses of disease-modifying antirheumatic drugs (DMARDs) is recommended with careful consideration for safety in RA patients with moderate or severe renal dysfunction.

Rheumatologists should treat RA patients positive for hepatitis B surface (HBs) antigen in collaboration with a hepatologist. Rheumatologists should treat hepatitis B virus (HBV)-infected RA patients negative for HBs antigen according to the usual treatment strategy with regular monitoring for HBV infection.

Rheumatologists should treat hepatitis C virus (HCV)-infected patients with RA according to the usual treatment strategy in collaboration with a hepatologist.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Rheumatoid Arthritis Clinical Practice Guidelines (JCR, 2022) - Medscape - Apr 05, 2022.

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