Carol Oatis

The medical management of rheumatoid arthritis (RA) has improved remarkably over the last 50 years. Today, disease-modifying antirheumatic drugs are staples of RA management and alone, or in combination with a plethora of biologic therapies, have reduced overall RA disease activity and related joint destruction. Under the treat-to-target approach, treatment is escalated until a target of remission or low disease activity is reached and promptly escalated when the target is no longer met (1, 2).

Challenges and recommendations for guideline implementation The recommendations only contribute to improving patient outcomes if they are fully integrated in clinical practice. However, their implementation can be hindered by challenges at the health professional, patient, and policy levels. Here, we highlight critical barriers and practical recommendations affecting key stakeholders.