The Rx Consultant 

Rheumatoid Arthritis

This CE activity was originally published in The Rx Consultant.  If you received credit for it previously, you cannot receive credit for it again.
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease characterized by immune system damage to multiple joints. It results in pain, physical disability, reduced quality of life, increased mortality, and significant socioeconomic costs. The estimated prevalence of RA is 0.5% to 1% of the population worldwide; women are 2 to 3 times more likely to be affected than men. RA can begin at any age; however, the onset is typically during the sixties. Up to 60% to 90% of individuals with RA have progressive destruction of joints, and as many as one-third are work-disabled within 2 years of disease onset.

Historically, initial RA treatment focused on corticosteroids and NSAIDs to reduce painful inflammation; eventually, nonresponders were given disease-modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX). Over the last decade, earlier and more aggressive treatment has been recommended to slow disease progression. Newer strategies include combination DMARD regimens and early use of biologic DMARDs that target specific components of the immune system. The American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR), have published treatment guidelines for RA that include the use of biologic agents alone or in combination with nonbiologic DMARDs. This issue will briefly review RA in adults, then focus on newer treatments including biologic agents (tumor necrosis factor [TNF] inhibitors and non-TNF inhibitors), delayed-release prednisone (Rayos®), and tofacitinib (Xeljanz®).
This CE activity is a monograph (PDF file).



CE Hours


CE Units


Activity Type


Target Audience(s)

Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses


This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.

CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours.  CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists: 
    This continuing education activity meets the requirements of:
        The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
        The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
    This is a pharmacotherapeutics/pharmacology CE activity.
  • The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
  • Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.  
  • Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Accreditation Council for Pharmacy Education
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Requirements for CE Credit

CE No Longer Valid
To receive CE credit, the participant must read the monograph in its entirety, complete the online post-test and receive a score of 70% or greater, and complete the online evaluation.
Pharmacists and Pharmacy Technicians -
Be sure your profile has been updated with your NAPB e-profile # and birth date information BEFORE completing the online evaluation, or your credits cannot be reported to CPE Monitor.
Continuing pharmacy education credit is automatically reported to CPE Monitor once the post-test & evaluation are successfully completed.




  • Describe the symptoms and natural course of rheumatoid arthritis (RA). Discuss treatment goals.
  • Discuss the role in RA therapy of nonbiologic DMARDs, TNF inhibitors, non-TNF biologic DMARDs, NSAIDs, & corticosteroids.
  • List at least 8 biologic drugs (TNF inhibitors, non-TNF agents) for RA. Discuss their main adverse effects and safety issues.
  • For each of the 2 new approvals (tofacitinib and DR prednisone): discuss the evidence supporting their use in RA. Provide 2-3 patient counseling tips.


Pamela Mausner, MD

Brief Bio : Pamela Mausner, MD; Medical Writer/Editor and Healthcare Advocate; and Associate Editor, The Rx Consultant.
Disclosure : Dr.Mausner reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Tracy Farnen, PharmD

Brief Bio : Tracy Farnen, PharmD; Managing Editor, The Rx Consultant.
Disclosure : Dr. Farnen reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

William J. Cardarelli, PharmD

Brief Bio : Dr. Cardarelli, Director of Pharmacy Revenue and Supply for Atrius Health and Harvard Vanguard Medical Associates in Boston, MA. He is a graduate of the University of Massachusetts and Massachusetts College of Pharmacy.
Disclosure : Dr. Cardarelli reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or istributing a product or service that appears in this issue.

Activity Number


Release Date: Mar 18, 2013
Credit Expiration Date: Mar 18, 2016

CE Hours