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About this site
RAoutlook.org is a free educational Web site designed to provide rheumatologists and other health care professionals with the latest information and education on advances in the management of patients with RA.
This section contains articles, written by healthcare professionals, covering a wide variety of topics related to the use of biologics in rheumatoid arthritis, as well as answers to questions posed by registered site users.
These reports are contributed by experts in the treatment of rheumatoid arthritis and offer insights into patient selection, dosing and administration, efficacy, side effects of biologic therapy, and overall disease management.
Joel M. Kremer, MD
The development of biologic therapies that target specific steps in the pathogenesis of rheumatoid arthritis has allowed clinicians to make great strides in the treatment of patients with this disease. Despite these advances, there remains a need for additional safe and effective rheumatoid arthritis treatments. In this Expert Practice, Dr. Joel M. Kremer of Albany Medical College and The Center for Rheumatology in Albany, New York discussed a number of new biologic agents in development for the treatment of rheumatoid arthritis. He reviewed recent clinical data for these agents and shared his insights on how they may fit into existing treatment paradigms.
Philip J. Mease, MD
Intensive management, or tight control, of rheumatoid arthritis (RA) has been shown to be associated with better patient outcomes. For this issue of Expert Practice, we interviewed Philip Mease, MD, Chief of Rheumatology Research at the Swedish Medical Center and Clinical Professor of Medicine at the University of Washington in Seattle, Washington. He provided insights regarding the benefits of maintaining tight control in the treatment of RA as well as tips on how to quantify disease activity.
Kenneth G. Saag, MD, MSc
In June 2008, the American College of Rheumatology (ACR) issued updated recommendations for using disease-modifying antirheumatic drugs (DMARDs) in the treatment of patients with rheumatoid arthritis (RA). The recommendations, which had not been updated since 2003, include biologic agents in their scope for the first time. Developed to reflect current standards in the management of RA, the updated recommendations include treatment algorithms based on accumulated scientific evidence. In this Expert Practice article, Dr. Kenneth G. Saag, a member of the Task Force Panel and lead author of the updated ACR recommendations, discusses the new recommendations, describing the role of disease activity assessment, safety monitoring, contraindications, and the use of specific agents in the management of RA.
Arthur Kavanaugh, MD
Cardiovascular disease (CVD) is a significant source of morbidity and mortality in the United States. Inflammatory conditions such as rheumatoid arthritis (RA) are associated with an increased risk for cardiovascular disease. In this Expert Practice Arthur Kavanaugh, MD, discusses the impact of cardiovascular risk factors on the management of patients with RA. Topics addressed include epidemiology of CVD and related risk factors in patients with rheumatoid arthritis, how rheumatoid arthritis treatment influences cardiovascular risk factors, and the overall management of rheumatoid arthritis patients with cardiovascular risk factors.
Mark Genovese, MD
In this Expert Practice, Dr. Mark Genovese, Associate Professor in the Division of Immunology and Rheumatology at Stanford University in Palo Alto, California, discusses the concurrent use of traditional disease-modifiying antirheumatic drugs (DMARDs) with other DMARDs or in combination with biologic agents for the treatment of rheumatoid arthritis (RA). Dr. Genovese also discusses the influence of patient factors and diagnostic tests on the decision to place a patient on combination therapy.
Roy M. Fleischmann, MD
In this Expert Practice interview Dr. Fleischmann discusses long-term safety issues associated with the biologic agents currently available to treat rheumatoid arthritis (RA). He also discusses comorbidities that influence the safety of biologics, as well as the pretreatment screening process for patients who are being considered for biologic treatment.
Marc Cohen, MD
Dr. Marc Cohen discusses the concept of early treatment as it relates to rheumatoid arthritis (RA) and the use of biologics. Dr. Cohen talks about the changing definition of early RA and the diagnostic tools currently in use, as well as the goal of treatment and the role biologics may play in achieving that goal.
By Gregg J. Silverman, MD
Gregg J. Silverman, MD, director of the Rheumatic Diseases Core Center at the University of California, San Diego, discusses the targeted use of B-cell therapy to treat rheumatoid arthritis (RA). This article details how current B-cell therapies influence the pathophysiology of RA, the general safety profile of such agents, and the possibility of combination therapy aimed at multiple RA-related targets. Dr. Silverman concludes by focusing on a theoretical model illustrating how B cells interact with other immune factors to result in an overall "immune homeostasis."
In the Doctor to Doctor section, health care professionals ask our panel of experts specific questions related to the use of biologic therapy to treat rheumatoid arthritis, covering such topics as clinical trial data, the utilization of biologic therapy in day-to-day practice, and strategies for insurance reimbursement.
August 26, 2009
Question:
What are the recommendations for patients who were tested for tuberculosis (TB) prior to initiating therapy with a biologic but did not receive all the vaccinations listed in the published American College of Rheumatology (ACR) recommendations?
