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a rheum arthritis imageJuly 13 2018

NICE has issued a new version of its guideline on the management of rheumatoid arthritis (RA), updating guidance from 2009 and the 2015 revisions.

Among the new recommendations in NICE guideline NG 100 are sections on: 

  • investigation after establishing a diagnosis of RA;
  • the treat-to-target strategy;
  • conventional disease-modifying anti-rheumatic drugs;
  • symptom control including use of oral non-steroidal anti-inflammatory drugs and factors to consider with NSAIDs;
  • monitoring of patients and frequency of review.

In addition to the above, there have been some amendments to existing guidance, as well as some changes without an evidence review to:

  • clarify when urgent referral is needed;
  • clarify when measuring anti-cyclic citrullinated peptide antibodies might be considered for diagnosis;
  • clarify that X-ray of the hands and feet applies to adults with suspected rheumatoid arthritis (RA);
  • clarify that other treatments rather than analgesics should be considered for people on low-dose aspirin (analgesics other than NSAIDs are no longer recommended);
  • clarify that all adults with RA should have an annual review, including those who have reached their treatment target.

Links:
NICE guideline NG 100: ‘Rheumatoid arthritis in adults: management’. July 2018

Among the new recommendations in NICE guideline NG 100 are sections on: 

  • investigation after establishing a diagnosis of RA;
  • the treat-to-target strategy;
  • conventional disease-modifying anti-rheumatic drugs;
  • symptom control including use of oral non-steroidal anti-inflammatory drugs and factors to consider with NSAIDs;
  • monitoring of patients and frequency of review.

In addition to the above, there have been some amendments to existing guidance, as well as some changes without an evidence review to:

  • clarify when urgent referral is needed;
  • clarify when measuring anti-cyclic citrullinated peptide antibodies might be considered for diagnosis;
  • clarify that X-ray of the hands and feet applies to adults with suspected rheumatoid arthritis (RA);
  • clarify that other treatments rather than analgesics should be considered for people on low-dose aspirin (analgesics other than NSAIDs are no longer recommended);
  • clarify that all adults with RA should have an annual review, including those who have reached their treatment target.

Links:

NICE guideline NG 100: ‘Rheumatoid arthritis in adults: management’. July 2018 

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