BSR/BHPR guideline for disease-modifying anti-rheumatic drug (DMARD) therapy in consultation with the British Association of Dermatologists

Abstract

Scope and purpose of the guideline Inflammatory arthritis and especially rheumatoid arthritis (RA) is common and affects 1% of the population. The prognosis of RA remains uncertain as it runs a variable and unpredictable course. Several longitudinal studies have demonstrated the progressive course of RA and new research has emphasized the need for early intervention with disease-modifying anti-rheumatic drugs (DMARDs) to prevent long-term disability. The development of Clinical Guidelines is the first step towards earlier diagnosis and treatment. This multidisciplinary and multiprofesssional guideline on DMARDs is timely for two major reasons: first, it was necessary to update the guideline produced by the British Society for Rheumatology (BSR) 5 yrs ago; and second, it was necessary to produce a unified approach to monitoring patients on some of the DMARDs particularly methotrexate due to recent developments with the national patient safety agency. Therefore, this guideline is somewhat unique, as BSR has taken a collaborative approach with the British Association of Dermatologists (BAD) to develop this document. This comprehensive evidence-based guideline on individual DMARDs gives a framework for monitoring the effects of these drugs that will help all health-care professionals across the primary and secondary care.