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CME: Rheumatoid Arthritis (RA): Optimizing Pharmacotherapeutic Management Strategies

Activity Description / Statement of Need:

In this online CME self-learning program:


Rheumatoid arthritis (RA) is a systemic autoimmune disorder in which joints, typically those in the hands and feet, become inflamed, swollen, painful, and stiff. Without appropriate treatment, the inflammation may become chronic and cause irreversible destruction of bone and cartilage in the affected joints as well as contribute to the development of clinically important co-morbid conditions with attendant morbidity and mortality. The National Arthritis Data Workgroup estimates that about 1.3 million U.S. adults (0.6% of the adult population) have RA. RA imposes a considerable disease burden. Patients with RA have substantially lower health-related quality of life (QOL) than the general population with lower overall scores for physical and mental health across all age groups.The RA disease burden also is associated with increased health care resource utilization. Notably, RA patients with low QOL are twice as likely to be hospitalized as RA patients with high QOL.


Some have suggested that criteria used for the past two decades are inadequate for addressing the disease burden of RA because by the time a physician detects rheumatoid nodules or radiographic erosion, the optimal time has passed for treatment initiation, representing a gap in care relating to diagnosis of disease. Another potential gap is illustrated by studies in which researchers demonstrated that a systematic, objective approach to therapy with Disease Activity Score-driven therapy yields superior outcomes to routine care.




Faculty introduction, disclosures

Introductory content [Learning Objective #1]

  • Epidemiologic studies
  • How the ACR criteria have changed over time: 1987 vs. 2010 with supporting illustrations
  • The role of biomarkers; contrast with rheumatoid factor in nonrheumatic diseases
  • The clinical spectrum and costs of RA
  • Prognosis, progression, and impact

Treatment of RA [Learning Objectives #2, 3, 4, & 5]

  • Treatment standard: early aggressive treatment
  • Goals of RA management
  • Extent of joint damage and changing approaches to care
  • Cytokine disequilibrium and mechanisms of RA therapies: DMARDs, NSAIDs, biologicals, injectable corticotropin gel
  • Traditional treatment pyramid for RA: sequential drug therapy
  • Evidence for changing medical practice over the last three to four decades: early referral, diagnosis, and treatment in RA
  • ACR treatment algorithm and 2015 guidelines for RA
  • Recent advances in care, including novel formulations, and emerging and future therapies
  • Measures of RA disease activity, and persistent disease activity with traditional disease-modifying antirheumatic drugs DMARDs
  • Probability of continuing and reasons for discontinuing DMARDs: a focus on optimizing adherence
  • Patient case(s)

Summary, conclusions, and best practice recap

Target Audience:

The following HCPs: rheumatologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in rheumatology; and any other HCP with an interest in or who clinically encounter patients with RA.

This program is supported by an educational grant from Mallinkdrodt

Release Date: September 04, 2017 -- Expiration Date: September 04, 2019

Faculty: Sharon Dowell, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Describe the pathophysiology of RA such that it might inform treatment mechanisms.
  • Describe professional guideline recommendations´┐Ż approaches to the diagnosis and treatment of RA and, where applicable, apply them to patient cases
  • Identify the currently available and emerging pharmacotherapeutic treatments for management of RA and apply them to patient cases using evidence-based medicine.
  • Evaluate a treatment plan for a specific patient with RA to optimize safety and efficacy, suggesting modifications for improvement, including the management of comorbidities.
  • Describe the challenges and barriers to care associated with treating patients with RA.



Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure:  Sharon Dowell, MBBS, Assistant Professor of Medicine Howard University Hospital, Washington, D.C. discloses that she received Research grant support from Bristol-Myers Squibb, Pfizer, and Genentech; is a member of the Speaker’s Bureau of Horizon Pharma, and has received funding for Clinical Trials from GlaxoSmithKline.


Disclosures of Educational Planners: Charles Turck, PharmD has no relevant conflicts of interest to disclose.


Commercial Support Disclosure: This program is supported by an educational grant from Mallinkdrodt


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Rheumatoid Arthritis (RA) : Therapeutic Updates and Optimizing Treatment

Psoriatic Arthritis: Therapeutic Updates and Optimizing Treatment