Disease improving anti-rheumatic drugs (DMARDs) are one of the main therapeutic drugs for rheumatoid arthritis (RA). In recent years, there have been important advances in basic and clinical research on DMARDs, such as research on the therapeutic mechanism of DMARDs, the emergence of new DMARDs, biological agents (Bio-DMARDs) and The new use of old drugs, etc. These advances provide rheumatologists with more options and new challenges for clinical use. In response, the European League Against Rheumatism (EULAR) organized a dedicated working group consisting of several rheumatologists to develop a series of recommendations for the pharmacological treatment of RA based on a systematic literature review as well as expert opinion, and modified these recommendations through the Delphi process, resulting in 15 recommendations for the treatment of RA with DMARDs. 1. Once RA is diagnosed. Traditional DMARDs should be used as early as possible. 2, The goal of treatment is to achieve remission or low disease activity as early as possible, with follow-up every 1 to 3 months and treatment regimen adjustment. 3, Methotrexate (MTX) is one of the drugs of choice for active RA. 4.If MTX is contraindicated or not tolerated, it can be replaced with salazosulfapyridine, leflunomide, injectable gold preparation, etc. 5, Patients who have not used DMARDs, with or without hormones, may consider DMARDs monotherapy (patients with poor prognostic factors should consider DMARDs combination therapy-translator’s note). 6.For patients treated with DMARDs monotherapy or combination therapy, small to moderate doses of hormones may be used for a short period of time if necessary, but they should be reduced as early and as soon as possible. 7.After the failure of the preferred traditional DMARDs, if the patient has poor prognostic factors, consider adding biological DMARDs, if the patient has no poor prognostic factors, switch to other traditional DMARDs. 8.When the patient has poor effect on MTX or other traditional DMARDs, in the case of combined or uncombined hormones. MTX combined with biological DMARDs can be considered. Tumor necrosis factor (TNF) antagonists are currently recommended. For example, adalimumab, Iceptab, golimumab, and certolizumab. 9. Patients who fail the first treatment with TNF antagonists may consider switching to other TNF antagonists, or biological agents such as abciximab, rituximab, and tocilizumab. 10. Patients with refractory RA or with contraindications to biologics and traditional DMARDs may be treated with azathioprine, cyclosporine A (or cyclophosphamide in special cases), alone or in combination. 11. All patients with RA should be considered for intensive therapy, with patients with poor prognostic factors benefiting most from intensive therapy. 12, If the patient is in sustained remission, a gradual reduction in dosage may be considered, starting with a reduction or discontinuation of hormones, and when biologics are combined with other traditional DMARDs, the biologic dosage should be reduced first. 13.Patients in long-term sustained remission, the dosage of traditional DMARDs can be cautiously reduced after joint discussion between doctors and patients. 14.Patients who have not used traditional DMARDs but have poor prognostic factors can consider MTX plus biologics combination therapy. 15.Treatment regimen should be adjusted according to disease activity, bone destruction, complications and safety factors.