Prescribing Advice for GPs

February NICE Guidance

February 25, 2009 at 11:43 am | In Prescribing Extra - Other |  Print | No Comments

The National Institute of Health and Clinical Excellence has published new guidance for the month of February.

There is one guideline that may impact on primary care, a clinical guideline on rheumatoid arthritis. This guideline recommends that treatment is started early during active disease in order to minimise damage to joints.

A combination of disease-modifying anti-rheumatic drugs (DMARDs) including methotrexate and one other DMARD are recommended to be started within 3 months of the onset of persistent symptoms. In addition, a short course of a steroid is recommended to provide symptomatic relief during a flare.

The guideline also details the place in therapy for analgesics (including non-steroidal anti-inflammatory drugs), long-term steroids and biological agents.

Finally, the guideline recommends that people with rheumatoid arthritis are offered access to a multi-disciplinary team (MDT) including:

• specialist occupational therapy if they have trouble with daily activities or hand function
• specialist physiotherapy to improve general fitness, flexibility and strength
• a podiatrist if they have particular foot problems

Action: Primary care clinicians should be aware of these new guidelines. Clinicians who see patients with rheumatoid arthritis will find this information useful.