Rheumatoid Arthritis: Diagnosis and Management
Effective Date: May 1, 2006
The guideline summarizes current recommendations for diagnosis and treatment of Rheumatoid
Arthritis (RA) for patients 16 years-of-age and older.
Rheumatoid Arthritis (RA) is not a benign disease. RA is associated with decreased life expectancy.
The risk of cardiovascular mortality is twice that of the general population. Affecting approximately
1% of the adult population, RA is associated with considerable disability. RA adversely impacts an
individual’s quality of life and results in increased financial burden both to the individual and society
through medical costs and loss of productivity.
It is now well recognised that there is a “window of opportunity” early in the disease process to initiate
treatment which will fundamentally change the course of the disease. Treatment must be started early
to maximise the benefits of medications and prevent joint damage. The use of traditional medications
in combination and the new biologic therapies has revolutionised the paradigm of RA treatment in
In this new era of RA treatment, specialist care has become increasingly important in managing
complex regimens. Access to timely specialized care is not universally available. This guideline is
intended to aid in initiating early recognition and intervention and managing patients with this chronic
The approach to care of patients with RA should be considered as falling into two groups.
Early RA (ERA) is defined as patients with symptoms of less than 3 months duration.
Patients with established disease who have symptoms due to inflammation and/or joint damage.
The treatment approach varies depending on whether the symptoms arise from inflammation or joint
damage making the differentiation vital.
Rheumatoid aRthRitis: diagnosis and management
Recommendations to improve quality of care
Recommendation 1 Differ