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:
- referral, diagnosis and investigations
- communication and education
- the multidisciplinary team
- pharmacological management
- timing and referral for surgery
- diet and complementary therapies.
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
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users 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 compliance 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.