The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / From Paper to Practice

From Paper to Practice

June 1, 2009 • By Gretchen Henkel

  • Tweet
  • Email
Print-Friendly Version / Save PDF

SAN FRANCISCO—Several converging currents put rheumatologists at risk of being caught in “the perfect storm,” believes Eric D. Newman, MD, director of rheumatology and vice chair of the Department of Medicine at the Geisinger Medical Center in Danville, Pa. Traditional healthcare faces increasing problems, therapies for rheumatoid arthritis (RA) are more effective but complex, and outcome expectations are increasing. But, as Dr. Newman and his fellow presenters at a session at the October 2008 ACR/ARHP Annual Scientific Meeting titled “2008 ACR Rheumatoid Arthritis Treatment Recommendations: How Can We Treat Our Patients Better?” proposed, the ACR’s proactive stance on treatment recommendations for RA can help rheumatologists chart a course for the future.

You Might Also Like
  • Rheumatoid Arthritis Practice Performance Project Spots Problems in RA Management
  • Rheumatology Informatics System for Effectiveness Registry Can Help Physicians Improve Practice Performance
  • ACR Publishes New Guide for RA Care
Explore This Issue
June 2009
Also By This Author
  • Winter 2021’s Awards, Appointments & Announcements in Rheumatology

In June 2008, the ACR unveiled the results of a prodigious work effort, “American College of Rheumatology 2008 Recommendations for the Use of Nonbiologic and Biologic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis.”1 The ACR session complemented these efforts by offering practical tools to implement the recommendations in a practice-based approach.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

RA Care Changing Rapidly

Believing that evidence-based clinical practice recommendations are necessary for increasingly busy clinicians, the ACR had asked a task force panel to address five objectives regarding the use of nonbiologic and biologic disease-modifying antirheumatic drugs (DMARDs) in patients with RA:

  1. Their indications for use;
  2. Assessing clinical response;
  3. Screening for tuberculosis (TB; biologics only);
  4. Monitoring for side effects; and
  5. The roles of cost and patient preference in decision making (biologics only).

First, presenter Kenneth G. Saag, MD, professor of medicine and epidemiology at the University of Alabama in Birmingham, was a member of the core expert panel that conducted the extensive literature review and helped guide, along with the working group, the development of the recommendations. An expert task force panel used a modified Delphi process to reach consensus and enrich response categories for clinically detailed scenarios that would lead to RA treatment strategies.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The resulting recommendations comprise a dynamic document, Dr. Saag pointed out. “These recommendations provide a framework for future efforts. Although they’re extensive in scope, they are not comprehensive. They are meant to complement but not to eclipse individualized patient care,” he said. Some of the newer biologic agents were not included in the recommendations because the evidence to date was insufficient to elicit consensus by experts. Dr. Saag hopes that future updates of the recommendations will address the effectiveness of switching biological medications of the same mechanism (e.g., TNF blockers) and sequential biologic therapies, among other questions.

Measure, Measure, Measure

One of the key themes introduced by the recommendations is the necessity to regularly appraise patients’ symptoms and responses to treatment. For instance, because treatment algorithms are keyed to level of disease activity (i.e., low, moderate, and high), it’s imperative that patients’ disease activity be assessed. The developers of recommendations did not specify which instruments clinicians should use but did say that it ought to be done.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Meeting Reports, Quality Assurance/Improvement, Rheumatoid Arthritis Tagged With: Quality, Rheumatiod arthritis, TreatmentIssue: June 2009

You Might Also Like:
  • Rheumatoid Arthritis Practice Performance Project Spots Problems in RA Management
  • Rheumatology Informatics System for Effectiveness Registry Can Help Physicians Improve Practice Performance
  • ACR Publishes New Guide for RA Care
  • New Position Paper Aims to Reduce Administrative Tasks in Healthcare

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)