Effective communication and education are vital from the outset, together with access to a multidisciplinary team that includes specialist occupational therapy and physiotherapy support. Psychological support services are also important.
Combination therapy
Evidence supports the early use of DMARDs, preferably within three months of the onset of persistent symptoms, to control pain and reduce disease activity and radiographic progression. Combination therapies using methotrexate and one other traditional DMARD, such as sulfasalazine plus short-term glucocorticoids, havebeenrecommended.1-3