[The patient with rheumatoid arthritis in general practice - what needs to be considered before and during therapy?]

Abstract

Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory autoimmune disease in Switzerland, affecting up to 1 % of patients. Accordingly, these patients are also frequently seen in general practitioner consultations. The first-line therapy consists of methotrexate +/- glucocorticoids. Further disease modifying antirheumatic drugs (DMARDs) are necessary depending on symptom control, disease activity and side effects. Therapy goals are 1. improving quality of life, 2. preventing bone destruction and 3. controlling inflammation and thus reducing cardiovascular mortality. Patients with RA have an increased risk of infection due to their disease and therapy. Vaccination status should be checked and screening for relevant infectious diseases should be carried out before starting treatment. This article is intended to provide an overview of the treatment options as well as screening and prophylaxis of infections in accordance with the current recommendations of the European Alliance of Associations for Rheumatology (EULAR) and the Swiss Society of Rheumatology (SGR).