Course

Drop the Anchor? DMARD Monotherapy for the Treatment of RA

We will explore the current body of evidence addressing the use of DMARD monotherapy, specifically biologic and targeted synthetic small molecule therapies, in patients with RA. What do the guidelines say about when to prescribe biologics or small molecules, and is monotherapy with these medications ever recommended?

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DROP THE ANCHOR? DMARD Monotherapy for the Treatment of RA

PROVIDED BY

Support for this activity has been made possible through educational grants from Lilly, AbbVie, and Pfizer.

TARGET AUDIENCE

This activity has been designed to meet the educational needs of nurses, nurse practitioners, and physician assistants. Other healthcare providers may also participate.

ACTIVITY DESCRIPTION

In this issue of Rheumatology Nurse Practice, we will explore the current body of evidence addressing the use of DMARD monotherapy, specifically biologic and targeted synthetic small molecule therapies, in patients with RA. What do the guidelines say about when to prescribe biologics or small molecules, and is monotherapy with these medications ever recommended? What do real-world practice patterns reflect? What does the data say about the efficacy and safety of biologics and small molecules, both as monotherapy and in combination with conventional DMARDs? Lastly, what are the current approaches to tapering regimens in patients who have achieved clinical remission?

LEARNING OBJECTIVES

After participating in the activity, learners should be better able to:

  • Identify situations when biologic and small molecule monotherapy might be appropriate in patients with RA
  • List at least three reasons why patients with RA may discontinue use of methotrexate
  • Discuss efficacy and safety data from clinical trials looking at the use of specific biologics and small molecules as monotherapy in patients with RA
  • Review the role of methotrexate in the prevention of antidrug antibodies and as a preventative measure for cardiovascular disease

DISCLOSURE STATEMENT

According to the disclosure policy of the Rheumatology Nurses Society, 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.

RELATIONSHIPS ARE ABBREVIATED AS FOLLOWS:

E: Educational planning committee
G: Grant/research support recipient
A: Advisor/review panel member
C: Consultant
S: Stock shareholder
SB: Speaker bureau
PE: Promotional event talks
H: Honoraria
O: Other

DISCLOSURES AS FOLLOWS:

Iris Zink, MSN, NP, RN-BC, has disclosed the following relevant financial relationships specific to the subject matter of the content included in this educational activity: AbbVie, Crescendo Biosciences, Horizon/SB; Pfizer/C.

Carrie Beach, BSN, RN-BC, has disclosed the following relevant financial relationships specific to the subject matter of the content included in this educational activity: Pfizer, Horizon, Novartis/A.

Jacqueline Fritz, RN, MSN, CNS, RN-BC, has disclosed the following relevant financial relationships specific to the subject matter of the content included in this educational activity: Lilly, AbbVie, Celgene, Horizon, Momenta Pharmaceuticals/A; Celgene, AbbVie, Genentech, Horizon/SB.

Cathy Patty-Resk, MSN, RN-BC, CPNP-PC, has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

Mariah Zebrowski Leach has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

INDEPENDENT CLINICAL PEER REVIEWER

This newsletter was reviewed by Tiffany Clark, CNP. Ms. Clark has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

OFF-LABEL PRODUCT DISCLOSURE

This activity will review off-label or investigational information of the following: Golimumab, infliximab, and baricitinib.

PLANNING COMMITTEE

Kim Cheramie, MSN, RN-BC, Lead Nurse Planner, Rheumatology Nurses Society, has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

Scott Kober, MBA, President, MedCaseWriter, has disclosed that he does not have any relevant financial relationships specific to the subject matter of the content of the activity.

Laura Trimingham, MD, Medical Writer, has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

Kevin D. Lyons, Executive Director of the Rheumatology Nurses Society and Chief Executive Officer of Lyons Den Solutions, LLC, has disclosed that he does not have any relevant financial relationships specific to the subject matter of the content of the activity.

ACCREDITATION AND CREDIT DESIGNATION

Nurses

Rheumatology Nurses Society is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (Provider No. P0500). Rheumatology Nurses Society designates this educational activity for 3.2 contact hours (3.2 pharmacotherapeutic contact hours).

METHOD OF PARTICIPATION

There are no fees to participate in the activity. Participants must review the activity information, including the learning objectives and disclosure statements, as well as the content of the activity. To receive CNE credit for your participation, please go to rnsnurse.org/rnpce and complete the post-test (achieving a passing grade of 70% or greater) and program evaluation. Your certificate will be emailed to you upon completion.

COPYRIGHT

© 2018. This CNE-certified activity is held as copyrighted © by Rheumatology Nurses Society. Through this notice, the Rheumatology Nurses Society grants 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).