摘要（巴西）：目的： 巴西风湿病学会建立类风湿关节炎治疗的共识。

方法：复习有证据的文献资料，并参考巴西风湿病专家的意见。

结果和结论：总共有20条建议：（1）应与患者共同讨论治疗方案；（2）一旦确诊类风湿关节炎，应立刻用病情改善药治疗，并定期调整方案以获得缓解；（3）风湿科大夫负责治疗；（4）应以化学合成病情改善药开始治疗；（5）甲氨蝶呤是可选择的药物之一；（6）使用两种方案的化学合成病情改善药物后仍无效者，应使用生物制剂；（7）特殊情况下，生物制剂应尽早使用；（8）抗TNF生物制剂是首选的生物制剂；（9）第一种生物制剂治疗失败后，可选用其他生物制剂；（10）有严重关节外表现的类风湿关节炎，可选用环磷酰胺和硫唑嘌呤；（11）口服激素应低剂量短期使用；（12）非甾类抗炎药应与病情改善药物联合使用；（13）开始治疗阶段，应每个月评估临床疗效和副作用；（14）建议理疗、康复锻炼和职业性治疗；（15）关节畸形可外科手术；（16）其他治疗不应该替代传统治疗；（17）推荐悉心规划怀孕生育；（18）推荐积极监测和处理并发症；（19）应记录预防接种情况，并及时注射；（20）积极监测和处理地方流行性传染病。

附原文：Abstract OBJECTIVE: To elaborate recommendations for the treatment of rheumatoid arthritis in Brazil.METHOD: Literature review with articles' selection based on evidence and the expert opinion of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology.RESULTS AND CONCLUSIONS: 1) The therapeutic decision should be shared with the patient; 2) immediately after the diagnosis, a disease-modifying antirheumatic drug (DMARD) should be prescribed, and the treatment adjusted to achieve remission; 3) treatment should be conducted by a rheumatologist; 4) the initial treatment includes synthetic DMARDs; 5) methotrexate is the drug of choice; 6) patients who fail to respond after two schedules of synthetic DMARDs should be assessed for the use of biologic DMARDs; 7) exceptionally, biologic DMARDs can be considered earlier; 8) anti-TNF agents are preferentially recommended as the initial biologic therapy; 9) after therapeutic failure of a first biologic DMARD, other biologics can be used; 10) cyclophosphamide and azathioprine can be used in severe extra-articular manifestations; 11) oral corticoid is recommended at low doses and for short periods of time; 12) non-steroidal anti-inflammatory drugs should always be prescribed in association with a DMARD; 13) clinical assessments should be performed on a monthly basis at the beginning of treatment; 14) physical therapy, rehabilitation, and occupational therapy are indicated; 15) surgical treatment is recommended to correct sequelae; 16) alternative therapy does not replace traditional therapy; 17) family planning is recommended; 18) the active search and management of comorbidities are recommended; 19) the patient's vaccination status should be recorded and updated; 20) endemic-epidemic transmissible diseases should be investigated and treated.

引自：da Mota LM, Cruz BA, Brenol CV, Pereira IA, Rezende-Fronza LS, Bertolo MB, de Freitas MV, da Silva NA, Louzada-Júnior P, Giorgi RD, Lima RA, da Rocha Castelar Pinheiro G; Brazilian Society of Rheumatology.2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis. Rev Bras Reumatol. 2012 Mar-Apr;52(2):152-74