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®).
- Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses
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.
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.
- 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.
Requirements for CE Credit
- 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.