This guideline covers the diagnosis and management of rheumatoid arthritis in adults.

In December 2015, recommendations were added on hand exercise programmes.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals and practitioners who care for adults with rheumatoid arthritis.
  • Commissioners and providers of services for adults with rheumatoid arthritis.
  • Adults with rheumatoid arthritis, and their families and carers.

This guideline was previously called rheumatoid arthritis: the management of rheumatoid arthritis in adults.

This guidance updates and replaces cox-II inhibitors for the treatment of osteoarthritis and rheumatoid arthritis (TA27) and the clinical effectiveness and cost effectiveness of anakinra for rheumatoid arthritis (TA72).

Next review date: to be confirmed

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)