Management of rheumatoid arthritis: summary of NICE guidance

doi:10.1136/bmj.b702

Published 16 March 2009, doi:10.1136/bmj.b702
Cite this as: BMJ 2009;338:b702

Practice

Guidelines

Management of rheumatoid arthritis: summary of NICE guidance

Chris Deighton, consultant rheumatologist ¹, Rachel O’Mahony, senior research fellow ², Jonathan Tosh, health economist³, Claire Turner, project manager², Michael Rudolf, consultant physician⁴, on behalf of the Guideline Development Group

¹ Department of Rheumatology, Derbyshire Royal Infirmary, Derby DE1 2QY , ² National Collaborating Centre for Chronic Conditions, Royal College of Physicians of London NW1 4LE , ³ Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield S10 2TN, ⁴ Department of Respiratory Medicine, Ealing Hospital, Ealing UB1 3HW

Correspondence to: C Deighton chris.deighton@derbyhospitals.nhs.uk

The first 150 words of the full text of this article appear below.

Rheumatoid arthritis is a chronic, progressive autoimmune diseaseassociated with inflammation principally in synovial jointsand affecting over 400 000 people in the United Kingdom.¹ Inrecent years it has become clear that pain and disability canbe avoided if the disease is recognised early and treated promptlyand appropriately. It is therefore crucial that all health professionalshave knowledge of the recognition, management, and appropriatereferral of patients with rheumatoid arthritis. This articlesummarises the recommendations in the guideline from the NationalInstitute for Health and Clinical Excellence (NICE) on the managementof rheumatoid arthritis, from early identification to managingchronic and severe disease.²

NICE recommendations are based on systematic reviews of bestavailable evidence. When minimal evidence is available, recommendationsare based on the opinion of the Guideline Development Group(GDG) of what constitutes good practice. Evidence levels forthe recommendations are given in italic in square brackets.