Management of rheumatoid arthritis.

The past few years have witnessed a major change in the approach to the treatment of rheumatoid arthritis. The present focus is on early recognition and prompt treatment with disease-modifying antirheumatic drugs of which methotrexate continues to be the drug of choice. Leflunomide is an important recent addition to the list of available drugs. The use of combinations of disease-modifying antirheumatic drugs is gaining wide acceptance. A better understanding of the pathobiology of rheumatoid arthritis has led to the development of targeted therapies such as tumour necrosis factor blockers. There are robust data to show the clinical utility of tumour necrosis factor blockers in patients with rheumatoid arthritis.