This thesis examines the evolution of rheumatoid arthritis (RA) treatment, focusing on advancements in therapeutic strategies and updated guidelines, particularly from the European League Against Rheumatism (EULAR).It explores RA’s pathophysiology and the importance of early diagnosis using imaging and biomarkers to prevent joint damage. Recent EULAR guidelines emphasize early methotrexate use, personalized treat-to-target approaches, and escalation to biologics or tsDMARDs based on disease severity and patient response. furthermore, clinical trials, such as the ARIAA trial with abatacept, are highlighted for there potential in preventing RA progression, though challenges like adverse effects and early diagnosis persist, which reminds us of the importance of ongoing research and trials.