csDMARDs play a central role in the management of systemic autoimmune rheumatic diseases (SARDs), supporting disease control, preventing long-term joint and tissue damage, and improving patient outcomes. Over recent decades, their use within early intervention and treat-to-target strategies has contributed significantly to improved quality of life for people living with these conditions.
Alongside their benefits, csDMARDs carry recognised risks, making appropriate pre-treatment screening, ongoing precautions and regular monitoring essential. The new guideline supersedes the 2017 BSR/BHPR guidance and reflects advances in clinical evidence, emerging treatment strategies and updated best practice, aligning recommendations with current standards of care.
The guideline is structured around five key sections, covering pretreatment evaluation prior to csDMARD initiation, drug-specific recommendations, considerations relating to comorbidities, blood test monitoring during therapy, and principles for shared care agreements. Each recommendation is supported by explanatory text outlining the underpinning evidence.
