Rheumatoid Arthritis

MDNG Primary CareNovember 2010
Volume 12
Issue 11

Access a collection of reliable, online rheumatoid arthritis resources for you and your patients.

//Medical Websites

Diagnostic Guidelines for Arthritis

At this site, The Johns Hopkins Arthritis Center houses American College of Rheumatology (ACR) classification criteria for rheumatoid arthritis, juvenile rheumatoid arthritis, determining progression of rheumatoid arthritis, determining clinical remission in rheumatoid arthritis, and functional status in rheumatoid arthritis. The site also includes ACR guidelines for medical management of and monitoring drug therapy in rheumatoid arthritis, as well as the ACR definition of improvement in rheumatoid arthritis trials and ACR recommendations fro monitoring hepatic safety in rheumatoid arthritis patients receiving methotrexate. Physicians can also link information on identifying and treating antagonist failures in rheumatoid arthritis, drug information, and rheumatoid arthritis trial measures in clinical practice.


//The Educated PatientTM

Arthritis Foundation: Rheumatoid Arthritis

Direct your patients with rheumatoid arthritis and their family members to this site to find reliable answers to such questions as “What is it?” “What causes it?” “What are the effects?” “How is it diagnosed” and “Who is at risk?” Treatment options are also reviewed, with key terms throughout linked to extensive information on such topics as fatigue and the cause of rheumatoid arthritis. Site visitors can also access information on arthritis that is specific to heart disease, women, diabetes, surgery, pain, alternative therapies, and self-treatment. Clicking on “cause of rheumatoid arthritis” under “What causes it?” will direct patients to an FAQ page that covers treatment, taking control, and what the future may hold for those with rheumatoid arthritis.


//Clinical Trials

Atherosclerosis in Rheumatoid Arthritis

Study Type:Observational

Age/Gender Requirement:18-80 years (male/female)

Sponsor:University of California, San Francisco

Purpose: To “investigate the link between rheumatoid arthritis and cardiovascular disease by studying inflammation, joint disease, cholesterol abnormalities, and endothelial function.”


Clinically Important Changes in Rheumatoid Arthritis

Study Type: Observational

Age/Gender Requirement: 18 years (male/female)

Sponsor: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Purpose: To explore what improvements in symptoms are important to patients, as physicians tend to evaluate improvement based on lab results, duration of morning stiffness, grip strength, number of swollen joints, and pain severity, giving less attention to whether improvements in these areas are important to the patients with rheumatoid arthritis.


Living Well with Rheumatoid Arthritis

Study Type: Interventional

Age/Gender Requirement:18-70 years (male/female)

Sponsor:Brigham and Women's Hospital

Purpose: To “evaluate the efficacy of an internal family systems-based arthritis self-management program in improving rheumatoid arthritis subjects' disease activity, independence and other health outcomes,” as well as “assess the efficacy of an IFS-based program in improving RA subjects' mental health symptoms.”


//Online CME

Combining Patient and Physician Perspectives for Better Outcomes in Rheumatoid Arthritis



Expires:April 23, 2011


Complete this activity for a review of the prodromal symptoms that accurately predict disease progression in people with rheumatoid arthritis, how to best coax patients into accurately providing their own perspective on their disease, and how to select “appropriate treatment options and perform clinical assessments based on the outcome of both personal and patient perspectives.”


RA and Granulomatous Infection



Expires:April 21, 2012


The types of disease and drug-related granulomatous infections that can occur in patients with rheumatoid arthritis, and how to reduce the risk of these and opportunistic infections in this patient population are the two main foci of this case-based lesson. Epidemiology and tuberculosis risk with TNF inhibitors are also covered.


Rheumatoid Arthritis: Tuberculosis Risk and Prevention



Expires:August 27, 2011


This program focuses on the risk of tuberculosis in patients with rheumatoid arthritis, the rationale behind screening for tuberculosis in this population, methods of testing for exposure to tuberculosis, and the safety of biologic disease-modifying antirheumatic drugs relative to tuberculosis in patients with rheumatoid arthritis. http://hcp.lv/drEQYH

Rheumatoid Arthritis: What to Do about TNF Failures



Expires:November 30, 2011


This interactive course explores therapeutic options for conventional as well as biologic medications following the failure of a TNF inhibitor in patients with rheumatoid arthritis, and factors that can influence one’s choice in a biologic agent in such situations.


Pharma Focus

Actemra (tocilizumab)


Tocilizumab for Rheumatoid Arthritis: A Cochrane Systematic Review

Journal:The Journal of Rheumatology (October 15, 2010; published online before print)

Authors:Singh J, Beg S, Lopez-Olivo M

Purpose:“To compare the benefit and safety of tocilizumab to placebo in patients with rheumatoid arthritis (RA).”

Results:Although tocilizumab was associated, in the study, with a significant increase in levels of cholesterol and the occurrence of any adverse event, no serious adverse events were associated with the agent when administered at the approved dose of 8mg/kg every four weeks. The authors concluded that “tocilizumab in combination with methotrexate/DMARD is beneficial in decreasing RA disease activity and improving function.”


Clinical Trials

Subcutaneous versus Intravenous Actemra in Moderate to Severe Active Rheumatoid Arthritis

Study Type:Interventional

Age/Gender Requirement:18 years (male/female)

Sponsor: Hoffmann-La Roche

Purpose: To “compare the efficacy and safety of subcutaneous (sc) versus intravenous (iv) administration of RoActemra/Actemra (tocilizumab) in patients with moderate to severe active rheumatoid arthritis.”


Tocilizumabversus Adalimumab in Rheumatoid Arthritis

Study Type:Interventional

Age/Gender Requirement:18 years (male/female)

Sponsor: Hoffmann-La Roche

Purpose: To “evaluate the efficacy and safety of tocilizumab [RoActemra/Actemra] versus adalimumab as monotherapy in patients with rheumatoid arthritis who are intolerant of methotrexate or where continued treatment with methotrexate is considered inappropriate.”


From the HCPLive Network

Actemra Attempts to Break into Pediatric Market

Roche, the makers of Actemra, seek to expand the indication for the rheumatoid arthritis drug to include the treatment of systemic juvenile idiopathic arthritis.


Catch Rheumatoid Arthritis Early with New Test

An FDA-approved test catches novel rheumatoid arthritis markers before it's too late.


Have Arthritis? Get Marriage Counseling

Being in a strong, positive marriage can help rheumatoid arthritis patients cope better than being in a shaky marriage.


Medicaid Patients Ditch Biologics for Rheumatoid Arthritis

Results of a recent study on Medicaid patients treated with biologic agents for rheumatoid arthritis indicates that levels of poor adherence and premature discontinuation are strong.


New Guidelines for Treating Rheumatic Disease

Experts offer recommendations in six key areas to treat rheumatic and musculoskeletal disease.


Tips on Managing Arthritis Pain

UCS's Dr. Tom Vangsness offers five tips for arthritis patients on how to help manage pain. The video was featured on a local ABC affiliate station.


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