Where Are We with RA? Prevention, Treatment & Management Challenges

Last, he reminded us to consider holistic approaches to pain, fatigue and mental health. “The management is way beyond pharmacology. There are guidelines from the ACR and EULAR to this effect. There is real biology at work here,” Dr. McInnes noted.^11,12

Preventing RA

As for the prevention of RA, Dr. McInnes briefly touched on three recent studies—APIPPRA, ARIAA and PRAIRI—that evaluated whether certain biologics could help prevent the development of full-blown RA in patients with pre-RA. APIPPRA and ARIAA showed that abatacept might show promise.^13,14 PRAIRI showed no benefit to single-dose rituximab at two years.¹⁵

In Sum

RA is complex, and the best care of the patient involves more than just controlling inflammatory arthritis and/or systemic manifestations of RA.

“Divide your patient into tissue states: immune state, brain state, bone state and cardiometabolic state,” Dr. McInnes counseled. When we think about the patient this way, we can truly provide whole-patient care.

Samantha C. Shapiro, MD, is a clinician educator who is passionate about the care and education of rheumatology patients. She writes for both medical and lay audiences and practices telerheumatology.

References

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