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<font size="4"><b>Balancing the Science and Art of Managing RA: A Focus on Treating to Target </font></b><br><font size="3">Clinical Conversations about the Multidisciplinary Approach to Patient Care</font>

Balancing the Science and Art of Managing RA: A Focus on Treating to Target
Clinical Conversations about the Multidisciplinary Approach to Patient Care



Time to Complete

1 hour


November 7, 2012


August 7, 2013

Maximum Credits

1.00 / AMA PRA Category 1 Credit(s)TM
1.00 / CE for Nurses

Accredited Provider

Commercial Supporter

Support for this activity has been made possible through an independent educational grant from

Program Description

Over the last two decades, advances in the treatment of rheumatoid arthritis (RA) have caused a “sea change” in the way that clinicians approach the management of RA. This movement towards a “treat-to-target” approach is based upon evidence that (a) proves early treatment with disease-modifying antirheumatic drugs (DMARDs) results in less joint damage and better physical functioning; (b) demonstrates improved outcomes with biologic agents; (c) provides validated core variables and composite measures to reliably assess disease activity; (d) shows treating to target regimens lead to better outcomes than traditional approaches; and (e) confirms that remission can be achieved in many patients.1

Recognizing the important roles rheumatologists, nurse practitioners, nurses, and physician assistants all play in the care of patients with RA, this activity will focus on a multidisciplinary approach to care.

1. Smolen JS, Aletaha D, Bijlsma JW, et al; T2T Expert Committee. Treating rheumatoid arthritis to target: recommendations of an international task force [published corrections appear in Ann Rheum Dis. 2011;70:1349; Ann Rheum Dis. 2011;70:1519]. Ann Rheum Dis. 2010;69:631-637

Intended Audience

This activity is designed to meet the educational needs of rheumatologists, nurses/nurse practitioners, physician assistants, and other healthcare providers who are involved in the care and management of patients with rheumatoid arthritis.

Educational Objectives

As a result of participating in this educational activity, learners will be better able to:

  • Implement practices that reflect treat-to-target strategies to support the goal of reaching remission in patients with RA
  • Incorporate tools that are effective and practical to assess early RA and to monitor response to treatment
  • Educate patients about treatment options and side effects in order to actively participate in their treatment decisions
  • Identify barriers to implementing treat-to-target strategies in clinical practice

Disclosure of Conflicts of Interest

According to the disclosure policy of American Academy of CME, Inc., all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence.

ANCC Information

ANCC Accreditation Feedback Line: 1-866-262-9730

The Accreditation Program of the American Nurses Credentialing Center is interested in the opinions and perspectives of the participants in accredited continuing nursing education activities, particularly those perspectives related to the presence of perceived bias* in the continuing education. For this reason, we are now providing a toll-free telephone number. Participants may access this number at any time to:

1. Tell us of any noted bias or conflict of interest in the education
2. Tell us of any concerns, compliments, or opinions
3. Tell us of a great experience
4. Tell us of an unpleasant experience
5. Tell us your thoughts on the process

Just call and tell us!

*Bias is defined as preferential influence that causes a distortion of opinion or of facts. Commercial bias may occur when an educational activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased.

NOTE: Statements of commercial support and/or conflict of interest disclosures do not represent bias. Such statements inform the learner that the provider has implemented a mechanism to identify and resolve all conflicts of interest prior to delivery of the educational material.

If you have any questions relating to the accreditation for this activity, please contact:
John JD Juchniewicz, MCIS, CCMEP
American Academy of CME, Inc.
2275 West County Line Road
Suite 6-329
Jackson, NJ 08527


Kori Dewing, DNP, ARNP
Virginia Mason Medical Center
Rheumatology Department
Seattle, Washington

Ms. Dewing has no relevant financial relationships with any commercial interests.

Gurjit S. Kaeley, MD, MRCP, FACR
Division Chief
Associate Professor of Medicine
Rheumatology Fellowship Program Director
Director, Musculoskeletal Ultrasound
University of Florida College of Medicine
Jacksonville, Florida

Gurjit S. Kaeley, MD, MRCP, FACR
Consultant – for clinical trial design: Abbott Laboratories
Grant Recipient/Research Support: SonoSite and Esaote (Unrestricted equipment loan to University of Florida College of Medicine, Jacksonville)
Promotional Speakers’ Bureau: Abbott Laboratories, Amgen, Pfizer

Joan McTigue, PA-C
University of Florida
College of Medicine and VA Medical Center
Division of Rheumatology
Gainesville, Florida

Ms. McTigue has no relevant financial relationships with any commercial interests.

William F.C. Rigby, MD (Activity Director)
Professor of Medicine, Microbiology and Immunology
Division of Rheumatology
Department of Medicine
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire

William F.C. Rigby, MD (Activity Director)
Advisory Board – for scientific information: Bristol-Myers Squibb, UCB Pharma
Consultant – for marketing purposes: Hoffman-La Roche
Consultant – for clinical trial design: Crescendo Bioscience, Hoffman-La Roche
Promotional Speakers’ Bureau: Hoffman-La Roche

Independent Clinical Peer Reviewer
Rodolfo V. Curiel, MD
, Assistant Professor of Medicine, Rheumatology Fellowship, Program Director, The George Washington University, Washington, DC: No relevant financial relationships with any commercial interests.

Planning Committee Disclosure

John JD Juchniewicz, MCIS, CCMEP, and Natalie Kirkwood, JD, BSN, RN (Lead Nurse Planner) American Academy of CME, Inc., and Deborah Dean, Michelle Yechout, and Wendy Gloffke, PhD (editorial assistance provided), Alliance Medical Communications: No relevant financial relationships with any commercial interests.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of American Academy of CME, Inc., (Academy) and Alliance Medical Communications. American Academy of CME, Inc., is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

American Academy of CME, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.




CE for Nurses

Accreditation Statement

American Academy of CME, Inc, is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Designation Statement

American Academy of CME, Inc., designates this educational activity for 1.00 contact hour.

Disclosure of Unlabeled Use

This activity will not review off-label or investigational information.

This activity is designed for use by health care professionals for educational purposes only. The opinions expressed in this educational activity are those of the faculty, and do not represent those of of American Academy of CME, Inc., Alliance Medical Communications, or American Nurses Credentialing Council’s Commission on Accreditation. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.

In addition, American Academy of CME, Inc., requires all faculty/authors to note the level of evidence for any patient care recommendation made during their presentations. For this activity, the Academy used the Category of Evidence and the Strength of Recommendation classification schemes from the 1999 British Medical Journal Clinical Guidelines (Shekelle PG, et al. Clinical Guidelines: Developing Guidelines. BMJ. 1999;318(7183):593-596.) for levels of evidence.

Category of Evidence:
 Ia Evidence for metaanalysis of randomized controlled trials
 Ib  Evidence from at least one randomized controlled trial
 IIa Evidence from at least one controlled study without randomization
 IIb Evidence from at least one other type of quasiexperimental study
 III Evidence from nonexperimental descriptive studies, such as comparative studies, correlation studies, and casecontrol studies
 IV Evidence from expert committee reports or opinions or clinical experience of respected authorities, or both

Strength of Recommendation:
 A  Directly based on category I evidence
 B   Directly based on category II evidence or extrapolated recommendation from category I evidence
 C  Directly based on category III evidence or extrapolated recommendation from category I or II evidence
 D  Directly based on category IV evidence or extrapolated recommendation from category I, II or III evidence


The information presented at this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.


There are no fees to participate in the activity. Participants must review the CME information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CME/CE credit for your participation, please complete the pre-activity survey and post-test (achieving a passing grade of 70% or greater), and program evaluation.

If you have any other questions relating to your certificate or other issues with this activity, please contact


© 2012. This CME-certified activity is held as copyrighted © by American Academy of CME, Inc., and Alliance Medical Communications. Through this notice, the Academy and Alliance Medical Communications grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).


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