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Patients with signs and symptoms of early rheumatoid arthritis (RA) should be referred to a multidisciplinary rheumatology clinic. The ACR-EULAR criteria help in identification of patients with risk for erosive RA. Treatment should aim at early remission. Start with the combination of methotrexate, hydroxychloroquine, sulfasalazine, and low-dose glucocorticoid is recommended if contraindications exist. Methotrexate has better bioavailability as injection. Glucocorticoids are injected into active joints. Patient education with shared decision is essential. Exercise training is recommended. If treatment target is not achieved by the DMARD combination, a biological drug is added.
有早期类风湿关节炎（RA）体征和症状的患者应转诊至多学科风湿病诊所。美国风湿病学会（ACR）和欧洲抗风湿病联盟（EULAR）标准有助于识别有侵蚀性RA风险的患者。治疗应旨在早期缓解。如果不存在禁忌证，建议开始联合使用甲氨蝶呤、羟氯喹、柳氮磺胺吡啶和低剂量糖皮质激素。甲氨蝶呤注射时生物利用度更好。糖皮质激素注射到活动关节。患者教育和共同决策至关重要。建议进行运动训练。如果DMARD联合治疗未达到治疗目标，则加用生物药物。
