Abstract

The availability of biological or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) has revolutionized the treatment of rheumatoid arthritis (RA). Given the changing landscape of RA management with the ever-expanding armamentarium of advanced therapeutic agents, guidelines are important to provide clinicians with recommendations for decisions frequently faced in clinical practice. To reflect the latest developments in RA research, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) updated their RA management guidelines in 2021 and 2022, respectively. While the general principles of management are largely similar, there are a few divergent recommendations. Two circumstances of particular attention include the polarized view on systemic glucocorticoid bridging and the position of Janus kinase (JAK) inhibitors in the RA treatment cascade. On the other hand, the EULAR recommendations might appear more directly applicable, whereas the ACR counterpart provides treatment guidance in special at-risk populations. In this presentation, the two latest recommendations from ACR and EULAR will be compared, highlighting the salient differences. The supporting literature will also be discussed, including the latest studies attempting to address the controversies in the management of patients with RA.

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