Management of early rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease typically affecting the small joints of the hands and feet. It is a long-term condition that results in persistent pain and stiffness, progressive joint destruction, functional decline and premature mortality.

Remit and target users

This guideline provides advice on the treatment of early RA (<5 years from symptom onset) and background information, recommendations and discussion on: diagnosis; principles of management; and disease modifying anti-rheumatic drug therapy. The guideline does not address the treatment of comorbidities, complications of drug therapy, or treatment of extra-articular disease.

This guideline will be of particular interest to rheumatologists, general practitioners, rheumatology nurse specialists, physiotherapists, occupational therapists, dietitians, podiatrists and pharmacists.

How this guideline was developed

This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.

Keeping up to date

This guideline was issued in 2011 and will be considered for review in three years. The review history, and any updates to the guideline in the interim period, will be noted in the review report.

If you are aware of any new evidence that would update this guideline please complete a change request form and return to: roberta.james@nhs.scot

​ Current 3-7 years

Some recommendations may be out of  date, declaration of interests governance may not be in line with current policy.