
Clinical Updates in Rheumatoid Arthritis
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Clinical Practice Guidelines
2015 American College of Rheumatology Guidelines for the Treatment of Rheumatoid Arthritis.
Singh JA, et al. Arthritis Rheumatol. 2016;68(1):1-26.
EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2013 Update
Smolen JS, et al. Ann Rheum Dis. 2014;73(3):492-509.
Treating Rheumatoid Arthritis to Target: 2014 Update of the Recommendations of an International Task Force
Smolen JS, et al. Ann Rheum Dis. 2016;75(1):3-15
Patient Resources
American College of Rheumatology
The American College of Rheumatology provides information for patients and caregivers that covers a breadth of topics, including the effects of rheumatoid arthritis (RA), importance of early treatment, access to biologic medications, patient advocacy, and more
Arthritis Foundation
The Arthritis Foundation provides self-care tools and resources covering treatment options, pain management, diet and exercise, and common comorbidities associated with RA.
NIAMS Handout on Health: Rheumatoid Arthritis
This National Institute of Arthritis and Musculoskeletal and Skin Diseases publication is a resource for patients and their families that describes how RA develops, how it is diagnosed, and how it is treated. It also highlights current research efforts and addresses what people can do to help self-manage their disease.
Rheumatoid Arthritis Support Network
The Rheumatoid Arthritis Support Network is dedicated to providing up-to-date information and resources for patients with RA.
Clinical Assessment Tools
American College of Rheumatology Disease Activity and Functional Status Assessment Online Calculators
The American College of Rheumatology has endorsed several RA disease activity measures, formatted as online calculators, to facilitate clinical decision-making.
Clinical Disease Activity Index (CDAI)
The CDAI for RA is a validated instrument that has providers survey 28 joints, the results of which are integrated with the patient’s and clinician’s global health assessment (Aletaha D, et al. Arthritis Res Ther. 2005;7(4):R796-R806).
Disease Activity Score (DAS28)
The DAS28 is a measure of RA disease activity that combines an assessment of 28 joints, results from laboratory testing (DAS28-ESR or DAS28-CRP), and a visual analog scale (Van Der Heijde DMFM, et al. J Rheumatol. 1993;20(3):579-581; Van Gestel AM, et al. Arthritis Rheum. 1998;41(10):1845-1850).
Routine Assessment of Patient Index Data 3 (RAPID3)
RAPID3 is a pooled index of the 3 patient-reported measures from the ACR Core Data Set for RA: function, pain, and patient global estimate of status (Pincus T, et al. Rheum Dis Clin North Am. 2009;35(4):773-778).
Simplified Disease Activity Index (SDAI)
Similar to the CDAI, the SDAI for RA has providers survey 28 joints, incorporates the patient’s and clinician’s global health assessment, and includes the circulating level of C-reactive protein (Smolen JS, et al. Rheumatol. 2003;42(2):244-257).
Suggested Readings
American College of Rheumatology Annual Meeting Abstract Archives
2016 Annual Meeting held in Washington, DC, November 11-16, 2016.
American College of Rheumatology Position Statement on Biosimilars
American College of Rheumatology. Released April 2016.
Annual European Congress of Rheumatology 2016 Abstracts
Hosted by the European League Against Rheumatism (EULAR) in London, England, June 14-17, 2016.
Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis
Choy E. Rheumatology (Oxford). 2012;51(suppl 5):v3-v11.
Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I.
Helmick CG, et al. Arthritis Rheum. 2008;58(1):15-25.
Safety and efficacy of biological disease-modifying antirheumatic drugs in older rheumatoid arthritis patients: staying the distance.
Ishchenko A, Lories RJ. Drugs Aging. 2016;33(6):387-398.
Cardiovascular risk and the use of biologic agents in rheumatoid arthritis.
Lim DT, et al. Curr Rheumatol Rep. 2014;16(11):459. 2012;130(2):332-342.e10.
Study of active controlled tocilizumab monotherapy for rheumatoid arthritis patients with an inadequate response to methotrexate (SATORI): significant reduction in disease activity and serum vascular endothelial growth factor by IL-6 receptor inhibition therapy.
Nishimoto N, et al. Mod Rheumatol. 2009;19(1):12-19.
Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial.
Gabay C, et al. Lancet. 2013;4:381(9877):1541-1550.
Preclinical lung disease in early rheumatoid arthritis.
Robles-Perez A, et al. Chron Respir Dis. 2016;13(1):75-81.
The pathogenesis of rheumatoid arthritis: new insights from old clinical data?
Smolen JS, et al. Nat Rev Rheumatol. 2012;8(4):235-243
Discontinuation of adalimumab after achieving remission in patients with established rheumatoid arthritis: 1-year outcome of the HONOR study.
Tanaka Y, et al. Ann Rheum Dis. 2015;74(2):389-395.
Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis
Young A, et al. Rheumatology (Oxford). 2007;46(2):350-357

Clinical Updates in Rheumatoid Arthritis
Howard Blumstein, MD; Allan Gibofsky, MD, JD; Jonathan Kay, MD
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Relevant Resources
Improved Diagnostic and Management Strategies
Long-Term Management Strategies to Improve Patient Outcomes
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Consensus and Controversies for Responsible Opioid Prescribing
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Treating to Target, IL-6-Directed Therapies, and Evolving Management Algorithms
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Clinical Updates in LDL-C Management
Improving Comprehensive Patient Care
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
Pathophysiology to the Management of Moderate-to-Severe Disease
Evolving Best Practices to Optimize Outcomes
Targeting Immune Dysregulation and Delivering Comprehensive Care
The PCP’s Role in Timely Recognition and Referral
Translating Comprehensive Patient Evaluations Into Personalized Therapy
Looking Beyond Barriers to Optimize Therapy
New Perspectives on Targeting Remission and Individualizing Therapy
Using Imaging to Improve Patient Outcomes
Discussions and Debates on the Evolving Roles of Targeted Synthetic DMARDs
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
Translating Pathophysiology into Targeted Treatments
Think You Know JAK?
An Interactive Experience Highlighting Recent Clinical Advances
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Debates & Discussions on the Evolving Role of JAK Inhibitors
Improving Patient Outcomes Through Shared Clinical Decision Making
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
The Evolving Role of JAK Inhibitors
Unpacking the Evidence for Their Use Today and Tomorrow
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
A PrEP Primer
A Foundation for Managed Care
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
The Increasing Role of JAK Inhibitors
Unlocking Novel Paths to Patient Care
New Pathways to Patient Management
A Focus on Clinical Evidence and Guideline Recommendations
Preventing COPD Exacerbations to Improve Outcomes
A Whole Patient Case Series
New Avenues to the Management of Severe Asthma
Getting on the Fast Track to Identify AxSpA
Establishing Clinical Readiness Through Mentored Learning
Interdisciplinary Strategies for Adult and Pediatric Patients
Interdisciplinary Management of Eosinophilic Esophagitis and Hereditary Angioedema
Reducing LDL-C and a Lifetime of Cardiovascular Risk
Updates, Clinical Scenarios, and Future Directions
A Multidisciplinary Look at Early Diagnosis and Management
Finding the Path in Chronic Rhinosinusitis with Nasal Polyps
Best Practices for Diagnosis and Management
An Update on Best Practices
New Avenues to Pre-Exposure Prophylaxis
Are You Aware of New Blood-Based Multi-Cancer Screening Tools
From Patient Evaluations to New Targeted Therapies
A Look at the Changing HIV Playing Field
A “How To” Series Spanning Policy to Practice
Test Your Mastery!
Building Bridges to Reach People who Inject Drugs with the Goal of Employing PrEP for HIV Prevention
Strengthening Your Knowledge of Blood-Based Screening Tools
Bringing HIV Prevention to a New Level
Optimizing HIV Prevention in Primary Care
What You Need to Know About New Blood-Based Screening Tools
Monoclonal Antibodies for the Prevention and Treatment of COVID-19
New Avenues to Improve Patient Outcomes
Exploring New Treatment Avenues in Nonadvanced Systemic Mastocytosis
Practical Updates on the 2023 GOLD Guidelines
A Phone-a-Friend CME Series – Volume 2
Incorporating New Data and Updated Guidelines Into Daily Practice
Focus on Psoriasis
Capitalizing on BCMA-Directed Therapies