RESUMO
A cure for rheumatoid arthritis is yet to be discovered. Although vast resources have been expended in the search for an immunological key to switch off the rheumatoid process, the most significant advances in the treatment of rheumatoid arthritis in recent times had come from gaining better understanding and skill in the safe use of existing disease modifying antirheumatic drugs (DMARDs). If prescribed appropriately and combined with adequate patient education and monitoring, Disease modifying anti-rheumatic drugs are safe and effective tools in the treatment of rheumatoid arthritis. The step down approach has been proposed for the treatment of patients with recent onset rheumatoid arthritis who have clinical features predictive of an adverse prognosis. More efficient ‘targeting’ of drugs at the site of desired action should help to minimize the adverse effects of therapy. Ultimately the most efficient way of relieving pain and stiffness will be to prevent or suppress the inflammatory disorders which give rise to the symptoms. Unfortunately this is a goal at present.