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Rheumatoid Arthritis Case Clinic 2: A 67-Year-Old Woman With Established Rheumatoid Arthritis

Rheumatoid Arthritis Case Clinic 2: A 67-Year-Old Woman With Established Rheumatoid Arthritis


Patient Case Study

Time to Complete

30 minutes


March 15, 2018


March 15, 2019
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Maximum Credits

0.50 / AMA PRA Category 1 Credit(s)TM

Accredited Provider

Provided by Haymarket Medical Education (HME)

Commercial Supporter

Supported by an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals

Program Description

Early diagnosis and prompt initiation of treatment are key goals in the management of rheumatoid arthritis (RA) and offer the best path to achieving remission or low disease activity. But when a patient presents later in the course of the disease, as in the case presented here, use of the “treat-to-target” approach advocated by both the American College of Rheumatology and the European League Against Rheumatism still applies. Frequent monitoring of disease activity and modifying treatment as needed according to the patient’s response still helps achieve the goal of remission or low disease activity.

Intended Audience

Rheumatologists, physician assistants, and nurse practitioners

Educational Objectives

After completing the activity, the participant should be better able to:

  • Recognize the full spectrum of rheumatoid arthritis (RA) manifestations, including the impact on functional ability, quality of life, and elevated risk for myocardial infarction and stroke
  • Implement guidelines-directed, treat-to-target strategies to achieve RA remission or low disease activity
  • Incorporate shared decision-making strategies in RA treatment decisions
  • Individualize RA treatment plans with consideration for patient-centric issues such as tolerability and likelihood of adherence in addition to efficacy and safety

Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, HME requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational activities.


Roy Fleischmann, MD, MACR, Chair
Medical Director
Metroplex Clinical Research Center
Clinical Professor of Medicine
University of Texas Southwestern Medical Center
Dallas, TX

Dr. Fleischmann reports that he is a consultant for AbbVie Inc., Amgen Inc., Eli Lilly, GlaxoSmithKline plc, Pfizer Inc., and Sanofi USA and receives fees for non-CME services from Pfizer Inc. He also receives research grants from AbbVie Inc., Amgen Inc., Eli Lilly, GlaxoSmithKline plc, Novartis, Pfizer Inc., Regeneron Pharmaceuticals Inc., Sanofi USA, Samumed LLC, and UCB Inc.

Bernard Combe, MD, PhD
Professor of Rheumatology
Montpellier University
Head, Bone and Joint Department
Montpellier University Hospital
Montpellier, France

Dr. Combe reports that he is a consultant for and is on the speakers’ bureaus of AbbVie Inc., Bristol-Myers Squibb Company, Chugai Pharmaceutical Co. Ltd., Janssen, Lilly, Merck Sharp & Dohme Corp., Pfizer Inc., and UCB Inc. He also receives research funds from Chugai Pharmaceutical Co. Ltd., Merck Sharp & Dohme Corp., and Pfizer Inc.

Accredited Provider Disclosures

Haymarket Medical Education staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.

Publishing Staff Disclosures

Lori Marrese and Jill Rovitzky Black have nothing to disclose in regard to commercial support.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

Haymarket Medical Education designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)TM  . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient’s medical condition.


The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Haymarket Medical Education, Sanofi Genzyme, or Regeneron Pharmaceuticals. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


To receive credit for this activity, the participant must complete the pre-activity questionnaire, post-test, and program evaluation. Participants must also score at least 70% on the post-test. Certificates will be distributed online at the conclusion of the activity. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

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