Treatments for rheumatoid arthritis (RA) are far more effective now than even 2 or 3 decades ago. The use of disease-modifying antirheumatic drugs (DMARDs), both conventional and biological, is largely responsible for this improvement, especially when treatment is initiated soon after disease onset. In populations with good access to experienced providers, extra-articular manifestations and joints with profound deformities are becoming less common, if not rare, and the goal has shifted to the induction and maintenance of low disease activity states from the more limited aim of slowing symptomatic and functional decline.