if newly diagnosed active rheumatoid arthirtis (RA)
offer a combination of DMARDs (including methotrexate and at least one other DMARD, plus short-term glucocorticoids) as first-line treatment as soon as possible, ideally within 3 months of the onset of persistent symptoms
if newly diagnosed RA for whom combination DMARD therapy is not appropriate
start DMARD monotherapy, placing greater emphasis on fast escalation to a clinically effective dose rather than on the choice of DMARD
Accepted combinations of DMARDS include:
methotrexate with any of the following:
cyclosporin A
infliximab
etanercept
leflunomide
sulfasalazine and hydroxychloroquine
sulfasalazine, hydroxychloroquine and prednisolone
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