Disease modifying drugs in adult rheumatoid arthritis

SYNOPSIS Effective treatment of rheumatoid arthritis now involves starting disease-modifying antirheumatic drugs at the time of diagnosis. This aims to slow development of the irreversible joint damage that leads to long-term disability. Many patients are treated with methotrexate. This is effective, but like other disease modifying drugs it has serious adverse effects. Monitoring patients is important particularly if they are taking a combination of drugs for their arthritis.