The outcome of rheumatoid arthritis in a single patient is frustratingly variable and unpredictable, but the illness leads to progressive disability in the majority of sufferers. Careful and continuous follow-up, aggressive medical treatment, an individualized exercise and dietary program, constant education and training, and psychological support are all important to enable the patient to maintain independence in daily living and in sustaining a home life and career. Multiple new medical therapies and strategies are being developed. At present, combination therapy with currently available drugs seems to be the most pragmatic tactic to control the patient with otherwise refractory disease.