What is the first-line treatment for active rheumatoid arthritis?

The first-line treatment for active rheumatoid arthritis is disease-modifying antirheumatic drugs (DMARDs). DMARDs are essential in the management of rheumatoid arthritis because they target the underlying disease process, aiming to slow or halt the progression of joint damage and improve long-term outcomes. Their mechanism of action involves modulating the immune response and reducing inflammation, which ultimately helps to preserve joint function and prevent disability.

While nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to manage pain and inflammation during exacerbations, they do not modify the disease course. Corticosteroids can also be effective for immediate symptom relief but are typically used for short-term management due to potential side effects with long-term use. Opioid analgesics might be prescribed for severe pain but do not address the inflammatory aspect of rheumatoid arthritis or the underlying disease progression.

Using DMARDs as the first-line treatment aligns with current clinical guidelines, which emphasize their role in achieving remission or low disease activity in patients with active rheumatoid arthritis. By focusing on administering DMARDs early in the disease course, clinicians can enhance patients' overall prognosis and quality of life.