Standard RA Review — SCE Rheumatology MCQ
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Correct answer: E — Assessment of disease activity and damage, functional ability, comorbidities and complications, life impact, and need for multidisciplinary or surgical referral
NICE recommends a comprehensive annual review for every adult with rheumatoid arthritis, including those who have achieved their treatment target. It should assess disease activity and damage, functional ability such as with the HAQ, and the effect of RA on daily life. It should also check for comorbidities including hypertension, ischaemic heart disease, osteoporosis and depression; seek symptoms of complications involving the vasculature, cervical spine, lungs or eyes; and consider multidisciplinary or surgical referral. DAS28 alone is therefore insufficient. Drug-safety blood monitoring remains necessary but is only one element of ongoing care, not a complete annual review. Review should not be restricted to flares, because annual review remains necessary in controlled disease. Routine radiography at every visit is not recommended.
Reference: National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management (NG100), section 1.9, recommendation 1.9.4. 2018, updated 2020 and surveillance reviewed 2024. https://www.nice.org.uk/guidance/ng100/chapter/Recommendations