These guidelines highlight the importance of early diagnosis and prompt initiation of disease-modifying antirheumatic drugs (DMARDs) in a stepwise manner, with the aim of achieving low disease activity or ideally remission, according to a composite disease activity score. DMARDs include conventional synthetics (e.g. methotrexate, leflunomide, sulfasalazine and antimalarials) biologics (e.g. etanercept, infliximab, adalimumab, tocilizumab) and targeted synthetics (e.g. tofacitinib, baricitinib). Systemic steroid use should be limited to short term and low dose to minimise the risks of adverse effects. Patients who achieve low disease activity or complete remission are at low risk of progression of joint damage, cardiovascular risk factors are normalised and quality of life is improved.

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