Conventional Disease-Modifying Antirheumatic Drugs for the Treatment of Rheumatoid Arthritis

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Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1359-000

Question

1. What are the evidence-based guidelines regarding the use of conventional disease-modifying antirheumatic drugs prior to the use of biologic disease-modifying antirheumatic drugs or Janus kinase inhibitors for the treatment of rheumatoid arthritis?

Key Message

Nine evidence-based guidelines were identified that recommend the use of conventional synthetic disease-modifying antirheumatic drugs as a first-line therapy for patients with rheumatoid arthritis prior to using biologic disease-modifying antirheumatic drugs or Janus kinase inhibitors. Methotrexate monotherapy was the most commonly recommended conventional synthetic disease-modifying antirheumatic drug recommended as first-line therapy by the included guidelines. Eight of the included guidelines recommend combination therapy using multiple conventional synthetic disease-modifying antirheumatic drugs if monotherapy is ineffective and 4 included guidelines recommend the use of glucocorticoids in combination with conventional synthetic disease-modifying antirheumatic drugs.