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Moreover, 6 weeks of chronic stress also revealed decreased relative abundance of Bacteroidetes and Deferribacteres (Jia et al., 2024)

[4] [5] The standard of care remains disease-modifying antirheumatic drugs (DMARDs), including conventional synthetic DMARDs like methotrexate as first-line therapy, with escalation to biological DMARDs or targeted synthetic DMARDs if disease activity remains inadequately controlled, following a treat-to-target approach

Patients should consult experienced clinicians, compare before-and-after goals, and proceed under medical supervision

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Use simple decision aids or visual tools if available, and invite patients to weigh the pros and cons with you