For health professionals

Key points

  • Optimise first-line disease modifying therapy before starting a biological/targeted synthetic disease modifying antirheumatic drug (b/tsDMARD).​
  • Subcutaneous methotrexate is more efficacious and generally better tolerated than oral methotrexate.
  • Consider stepwise reduction in the dose of b/tsDMARDs for people with rheumatoid arthritis (RA) or axial spondyloarthritis (axial SpA) who have been in remission or sustained low disease activity for at least 6 months, but do not stop b/tsDMARDs suddenly.​
  • Biosimilars are safe and equally effective alternatives to the reference biologic.​
  • Glucocorticoids and opioids have a limited role in the long-term management of inflammatory arthritis and should be used with caution.

Value in prescribing bDMARDs program for rheumatologists

Professor Catherine Hill, ARA President and rheumatologist, outlines how the bDMARDs program will help specialists and their patients, the gaps the program will cover and some of the useful resources that will be available.

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Educational visiting for specialists

Educational visits will cover a range of clinical updates based on the best available current evidence, developed with and informed by feedback from specialists. The updates are delivered through individualised 30-minute discussions at the preferred timing of the specialist, either online or face-to-face where COVID precautions allow. (Cost: Free)

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In focus

The Australian Living Guideline for inflammatory arthritis

This living guideline presents the best available, current scientific evidence for pharmacological management RA, PsA and axial SpA, including choice of DMARD, combination therapy and down-titration of treatment. The guideline will be continuously updated as relevant new evidence emerges, and includes:

  • Dose Reduction and Discontinuation Strategies
  • Opioids for Pain Management
  • Glucocorticoid therapy as an adjunct to DMARD therapy in the treatment of rheumatoid arthritis
  • Initial DMARD therapy for people with rheumatoid arthritis
  • Perioperative use of DMARDs in people with inflammatory arthritis

Find the Australian living guideline for the pharmacological management of inflammatory arthritis here

Video: A new living guideline to provide direction for the pharmacological management of inflammatory arthritis

Dr Sam Whittle, Cochrane Musculoskeletal Alliance member and rheumatologist, introduces the living guideline, explaining how it is developed and the gaps in the evidence it will address.

MedicineWise App

The MedicineWise app is a free health and medicines management app. Features have been developed to support people with inflammatory arthritis, including a dose tracker to manage complex dosing or stepping up or stepping down of medicines.

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TARGETED THERAPIES ALLIANCE

Helping consumers and health professionals make safe and wise therapeutic decisions about biological disease-modifying antirheumatic drugs (bDMARDs) and other specialised medicines. Funded by the Australian Government Department of Health through the Value in Prescribing bDMARDs Program Grant.