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Astra Clinical Library

Rheumatology

Practical rheumatology guides for clinical decisions, with cited evidence, testing strategies, and actionable next steps.

10 guides

Rheumatology

Giant Cell Arteritis

Treat suspected giant cell arteritis immediately when ischemic manifestations are present, while rapidly confirming cranial and large-vessel disease with vascular imaging and/or temporal artery biopsy.
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Rheumatology

Systemic Lupus Erythematosus

Manage SLE by confirming a clinical autoimmune phenotype, rapidly identifying renal, neurologic, hematologic, thrombotic, and cardiopulmonary threats, then using hydroxychloroquine and early steroid-sparing therapy to control activity while limiting glucocorticoid damage.
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Rheumatology

Gout

Manage gout by confirming or strongly supporting monosodium urate deposition, excluding septic arthritis in an acutely inflamed joint, selecting flare therapy by comorbidity, and using treat-to-target urate lowering with prophylaxis to dissolve deposits and prevent recurrent disease.
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Rheumatology

Rheumatoid Arthritis

Rheumatoid arthritis management depends on prompt initiation of a conventional DMARD, predefined assessment against remission or low disease activity, and rapid treatment adjustment when the target is missed. Therapy selection must balance inflammatory control with methotrexate tolerance, prior DMARD response, infection risk, and cardiovascular risk factors.
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Rheumatology

Polymyalgia Rheumatica

Manage suspected polymyalgia rheumatica by excluding concurrent giant cell arteritis and mimics before committing to prolonged glucocorticoids, then use individualized prednisone tapering with serial assessment of disease activity, inflammatory markers, and treatment toxicity.
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Rheumatology

Behçet Disease

Behçet disease requires phenotype-directed care: recognize clinical diagnostic patterns, urgently identify ocular, neurologic, vascular, and gastrointestinal involvement, and match immunomodulatory treatment to threatened organs rather than mucocutaneous activity alone.
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Rheumatology

Mixed Connective Tissue Disease

Mixed connective tissue disease requires anti-U1-RNP positivity plus an evolving overlap phenotype. Initial management hinges on detecting pulmonary arterial hypertension, interstitial lung disease, inflammatory myopathy, and cardiac involvement before assigning organ-directed immunosuppression and cardiopulmonary care.
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Rheumatology

Gout Flare Treatment in CKD

Treat acute gout promptly while excluding septic arthritis and avoiding renal and cardiorenal toxicity. In chronic kidney disease, select colchicine cautiously, favor targeted or systemic glucocorticoids when appropriate, reserve IL-1 blockade for refractory contraindicated cases, and continue long-term urate control.
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Rheumatology

Giant Cell Arteritis Immediate Management

Treat suspected giant cell arteritis immediately when cranial ischemia is possible: obtain inflammatory markers and urgent diagnostic testing without delaying glucocorticoids, stratify visual and cerebrovascular threat, and add steroid-sparing therapy when prolonged immunosuppression is anticipated.
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Rheumatology

Dermatomyositis

Dermatomyositis requires prompt phenotyping for muscle disease, dysphagia, interstitial lung disease, and cancer risk. Combine characteristic cutaneous findings with enzyme testing, myositis serology, MRI-directed biopsy when needed, baseline pulmonary evaluation, and risk-stratified malignancy screening.
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