Contemporary approach for the treatment of rheumatoid arthritis

Abstract:

Over the last two decades, the treatment of rheumatoid arthritis has significantly improved. In addition to conventional synthetic drugs that modify the disease, there are nine biological medicines being used that enable the achievement of remission of rheumatoid arthritis in a large number of patients. Generally accepted principles for the treatment of rheumatoid arthritis are the early use of disease-modifying medications in adequate doses, frequent control with thorough monitoring of treatment outcomes, replacement or a combination of existing medications in case of insufficient clinical response, the use of biological medicines in patients who do not achieve remission or low activity of the disease with conventional synthetic medications, as well as replacement of biologic medications after failure of first-line biologic therapy. It is important that the use of glucocorticoids as additional medication is properly managed. The efficacy of medications is indisputable, however, there are still some controversial issues left, such as the choice of monotherapy or combination of first-line medications, selecting the first biological medicine and the optimal order of replacement of biological therapy, all with the aim to achieve remission in all patients. 

Key words:
biological medicines; disease modifying medications; remission; rheumatoid arthritis; treatment