NICE updates guidance for managing RA

NICE has set out updated advice on managing RA, with new recommendations on treatment, the aim of treatment, symptom control and monitoring.

Rheumatoid arthritis (Photo: iStock)
Rheumatoid arthritis (Photo: iStock)

NICE has published new draft guidance on the management of RA in adults this week. Originally launched in 2009, the guidance was last reviewed by NICE in 2015. The current draft will be open for consultation until 1 March this year.

In a change from NICE’s earlier recommendations, it advocates starting treatment with just one cDMARD drug instead of a combination of cDMARDs. Further cDMARDs should be added if treatment targets are not met despite dose escalation.

The aim of treatment should be remission or ‘low disease activity’ if remission cannot be achieved, it says.

Prescribing

It also newly recommends prescribing NSAIDs to help control symptoms of pain or stiffness if required.

Patients should be given review appointments every six months after achieving treatment targets. If the treatment target is maintained for at least one year without glucocorticoids, it advises doctors to consider reducing or withdrawing drugs in a step-down strategy.

NICE said: ‘We have reviewed the evidence and updated or added new recommendations on investigations following diagnosis, treat-to-target strategy, initial pharmacological management, symptom control and monitoring.’

Around 1.5 men and 3.6 women per 10,000 people develop RA each year, with the disease most likely to occur when patients are in their 70s.

Swedish research published last year found that taking the oral contraceptive pill for seven years or more continuously was linked to a 19% reduced risk of RA.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

RCGP chair 'livid' over attacks on general practice from 'armchair critics'

RCGP chair 'livid' over attacks on general practice from 'armchair critics'

General practice has risen 'heroically' to unprecedented challenges during the COVID-19...

Remote GP consultations a 'lifeline for the NHS' during pandemic, says Hancock

Remote GP consultations a 'lifeline for the NHS' during pandemic, says Hancock

The rapid switch to remote GP consultations during the COVID-19 pandemic provided...

COVID-19 disrupted training for four in five doctors, GMC survey shows

COVID-19 disrupted training for four in five doctors, GMC survey shows

The vast majority of trainee doctors have seen their training disrupted or limited...

GP practices face losses 'in excess of £50,000' as COVID-19 hits income

GP practices face losses 'in excess of £50,000' as COVID-19 hits income

GP practices across England are facing a significant loss of income as COVID-19 dries...

MPs explore GP workload cap and flag damaging impact of intense pressure

MPs explore GP workload cap and flag damaging impact of intense pressure

MPs have raised the prospect of a cap on GP consultations in an investigation into...

GP training: Working remotely as a GP trainee during the pandemic

GP training: Working remotely as a GP trainee during the pandemic

Dr Zoe Brown was in her first year of GP training and pregnant as lockdown began....