Updates in Improving Care of Patients With Rheumatoid Arthritis

Rheumatoid arthritis (RA) remains a clinically-challenging autoimmune disorder for rheumatologists to manage. Effective patient care is critical: an estimated sixty percent of people with inadequately-treated RA are unable to work 10 years following onset of the disease. The American College of Rheumatology (ACR) has endorsed the use of several quality improvement measures in RA management, including recommended screening, disease activity assessment, and treatment guidelines. However, clinical care of patients with respect to guideline recommendations continue to be suboptimal.

A major reason for gaps in care of patients with RA is the ever-increasing amount of data being reported. The management paradigm for RA is evolving; increases in knowledge of RA pathophysiology, enhanced assessment tools and the emergence of biologic and nonbiologic therapies targeted to key pathways in RA result in an overwhelming amount of new information. Rheumatologists must assess key information and decide which to apply in clinical practice.

This activity is intended to provide rheumatologists with critical updates in care of patients with RA reported at the 2016 ACR Annual Meeting. Areas of focus include tracking and measuring disease progression, as well as predicting positive outcomes of RA, and updates on integration of biosimilars into clinical practice. Early use of traditional or biologic disease modifying antirheumatic drugs (DMARDs) have now made disease remission a realistic goal for many patients. How and when tapering RA therapy in patients with low disease activity is possible will be discussed. Finally, the activity will address multimorbidity, taking the concept of comorbidity in patients with RA and refining it to focus care upon the patient, rather than the disease.


This activity has been designed to meet the educational needs of health care professionals involved in the diagnosis, treatment, or management of patients with rheumatoid arthritis (RA).


Upon completion of this activity, participants will be better able to do the following:

  1. Describe methodologies and factors that can be used to predict disease progression, comorbid disease, response to treatment, and clinical outcomes in patients with RA
  2. Discuss considerations in the expanding clinical use of biosimilars as biologic DMARDs in RA treatment
  3. Explain how and when to stratify patients with low RA disease activity as potential candidates for tapering therapy
  4. Define multimorbidity and how it differs from comorbidity in approaches to patient care


Robert H. Shmerling, M.D.
Clinical Chief, Division of Rheumatology
Beth Israel Deaconess Medical Center
Boston, MA

Disclosure of Conflicts of Interest

It is the policy of the Elsevier Office of Continuing Medical Education that all faculty, instructors, and planners disclose any real or apparent conflicts of interest relating to the topics of this educational activity. 

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Relationship Identified With:
Robert H. Shmerling, MD
No relationships to disclose

Non-faculty: Sherlyn B. Celone-Arnold; Chris Blagden, PhD; Sandy Breslow; Alison Kemp; and Bernard M. Abrams, MD hereby state that neither they nor their spouse/life partner have had any financial relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Financial Support

This activity has been supported by an independent educational grant from Amgen Inc.

Provider Information

Jointly provided by the Elsevier Office of Continuing Medical Education, Integrated Learning Partners, LLC., and Consultants in Medical Education.



CME Credit (Physicians) 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Elsevier Office of Continuing Medical Education, Integrated Learning Partners, LLC., Consultants in Medical Education. The Elsevier Office of Continuing Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

The Elsevier Office of Continuing Medical Education designates this enduring activity for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For all CME inquiries or special needs, please contact elsevierCME@elsevier.com.

Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Elsevier Office of Continuing Medical Education, Integrated Learning Partners, Consultants in Medical Education, and Amgen Inc. do not recommend the use of any agent outside of the labeled indications.

Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Course summary
Available credit: 
  • 1.75 AMA PRA Category 1 Credit(s)™
  • 1.75 Non-physician
Course opens: 
Course expires: 

Available Credit

  • 1.75 AMA PRA Category 1 Credit(s)™
  • 1.75 Non-physician
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