In today’s world, where rheumatoid arthritis cannot be cured, preventing joint destruction, preserving joint function, and maximizing the quality of life of patients are our highest goals; therefore, the timing of treatment is very important. Early aggressive and rational treatment with DMARDs is the key to reduce disability . Although NSAIDs and glucocorticoids can reduce symptoms, joint inflammation and destruction can still occur or progress. Available DMARDs have the potential to reduce or prevent the effects of joint destruction. The principle of treatment of rheumatoid arthritis is the rapid administration of NSAIDs to relieve pain and inflammation and the early use of DMARDs to reduce or delay bone destruction. It is important to note that the choice of drugs should be in accordance with the principles of safety, effectiveness, economy and simplicity. Patients with rheumatoid arthritis are started on DMARDs as soon as they are diagnosed. Commonly used ones such as methotrexate (MTX), salazosulfapyridine, and hydroxychloroquine are recommended. Depending on the condition, two or more DMARDs can be used alone or in combination. Patients with progressive, poor prognosis and refractory rheumatoid arthritis may be treated with a combination of DMARDs with different mechanisms. When combined, the adverse effects are not necessarily more than with a single drug. When combined, the dose of each of these drugs can be reduced appropriately, such as MTX can be used 7.5mg-25mg/week and salazosulfapyridine 1.0~3.0g/day. At present, the commonly used combination programs are: ① MTX + salazosulfapyridine; ② MTX + hydroxychloroquine (or chloroquine); ③ MTX + penicillamine; ④ MTX + jinnovine; ⑤ MTX + azathioprine; ⑥ salazosulfapyridine + hydroxychloroquine. The combination of MTX and botanicals (e.g., leucovorin, penicillin, and total glucoside of peony) can also be used in China. If patients cannot tolerate MTX, they can switch to leflunomide or other DMARDs, and refractory rheumatoid arthritis can be treated with MTX + leflunomide or a combination of DMARDs. It must be emphasized again that no matter which treatment option is chosen, both hands (including the wrist) must be X-rayed or symmetrical X-rays of the affected joints must be taken before treatment, and the X-rays must be reviewed yearly after treatment to compare the efficacy. To avoid adverse drug reactions, the blood and urine routine, liver and kidney function should be closely monitored and the dose should be adjusted at any time during the course of treatment. The evaluation of treatment response should include the evaluation of functional status and the overall assessment of disease activity by the physician and the patient, in addition to the comparison of joint pain, swelling and number of joints before and after treatment, and radiological changes in the affected joints. The activity of the disease should be monitored in all patients. Patients with early, acute, or persistent disease activity should be followed closely until the disease is controlled. Patients in remission can be followed up every six months, and at the same time, the corresponding indicators should be tested regularly according to the requirements of the therapeutic drugs. DMARDs can slow down the progression of disease, but they cannot cure rheumatoid arthritis, so in order to prevent recurrence of the disease, in principle, the medication should not be stopped, but it can be gradually reduced to maintain the treatment until it is finally discontinued. Most patients with rheumatoid arthritis have a prolonged disease course, and the disability rate is high in the first 2-3 years of rheumatoid arthritis, and if not treated early and reasonably, joint destruction reaches 70% within 3 years. Active and correct treatment can lead to remission in more than 80% of patients with rheumatoid arthritis, with only a few eventually becoming disabled. There are no accurate indicators to predict prognosis, but it is usually believed that: men have a better prognosis than women; those with late onset of disease have a better prognosis than those with early onset of disease; the number of joints involved at the onset of disease or the number of metatarsophalangeal joints involved, or the number of joints involved in the course of disease is greater than 20 has a poor prognosis; persistent high titer rheumatoid factor positivity, persistent increased sedimentation, increased C-reactive protein, and increased eosinophils in the blood all indicate a poor prognosis; and the presence of severe The prognosis is poor if there are severe peripheral symptoms (fever, anemia, weakness) and extra-articular manifestations (rheumatoid nodules, sclerositis, interstitial lung disease, pericardial disease, systemic vasculitis and other visceral injuries); the prognosis is poor if the symptoms are difficult to control with short-term hormone therapy or the maintenance dose of hormone cannot be reduced to less than 10 mg/day.