From the Guidelines
The recommended treatment for rheumatoid arthritis involves starting with methotrexate, with a target dose of 25-30 mg/week, and adjusting as needed to achieve low disease activity or remission, as supported by the most recent evidence from 1. The treatment approach should be individualized, taking into account the patient's disease activity, risk factors, and comorbidities.
- Key principles of treatment include:
- Starting DMARD therapy as soon as possible after diagnosis
- Aiming for a target of sustained remission or low disease activity
- Monitoring disease activity regularly and adjusting treatment as needed
- Considering the use of biologic agents or targeted synthetic DMARDs in patients who do not respond to conventional DMARDs
- The choice of DMARD therapy should be based on the patient's specific needs and circumstances, with methotrexate being a common first-line option, as recommended by 1.
- Regular monitoring of disease activity and adjustment of treatment is crucial to achieve optimal outcomes, as emphasized by 1.
- Lifestyle modifications, such as regular physical therapy, exercise, and joint protection techniques, are also essential complementary approaches to manage rheumatoid arthritis, as supported by the evidence from 1.
From the FDA Drug Label
The recommended subcutaneous dosage of HULIO for adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) is 40 mg administered every other week Methotrexate (MTX), other non-biologic DMARDS, glucocorticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), and/or analgesics may be continued during treatment with HULIO. In the treatment of RA, some patients not taking concomitant MTX may derive additional benefit from increasing the dosage of HULIO to 40 mg every week or 80 mg every other week.
The recommended treatment for rheumatoid arthritis is 40 mg of adalimumab (HULIO) administered every other week, which can be used alone or in combination with methotrexate (MTX) or other non-biologic disease-modifying anti-rheumatic drugs (DMARDs) 2.
- Key treatment options include:
- Adalimumab (HULIO) 40 mg every other week
- Methotrexate (MTX)
- Non-biologic DMARDs
- Glucocorticoids
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Analgesics
- Dosage adjustments may be necessary for some patients, with the option to increase to 40 mg every week or 80 mg every other week if not taking concomitant MTX 2.
From the Research
Rheumatoid Arthritis Treatment Overview
- Rheumatoid arthritis (RA) treatment involves a combination of medications, including analgesics, non-steroidal anti-inflammatories (NSAIDs), glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs) 3, 4, 5.
- The primary goal of RA treatment is to reduce inflammation, relieve symptoms, and slow disease progression.
Disease-Modifying Antirheumatic Drugs (DMARDs)
- DMARDs are a class of drugs that can slow the progression of RA and save the joints and other body structures from permanent damage 4, 5, 6.
- Commonly used DMARDs include methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine 3, 4, 5.
- Methotrexate is often used as the initial treatment, and other DMARDs may be added if the response is inadequate 5.
Biologic Agents
- Biologic agents, such as anti-TNF agents, are used in patients who have not responded to traditional DMARDs or have severe disease 3, 4, 7.
- Anti-TNF agents, including etanercept and infliximab, have been shown to be effective in reducing disease activity and slowing disease progression 7.
- Other biologic agents, such as abatacept and rituximab, may also be used in the treatment of RA 3, 4.
Treatment Guidelines
- Current treatment guidelines recommend starting effective treatment immediately with DMARDs to reduce disability and aiming for a treat-to-target strategy with a goal of low disease activity or remission 5.
- Treatment should be escalated rapidly if the response to initial therapy is inadequate, and patients should be frequently monitored to assess disease activity and adjust treatment as needed 5.