Managing Managed Care

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Joint Disease

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The diagnosis and management of such rheumatologic conditions as rheumatoid arthritis (RA) has improved in the past decade.

We see more specific testing--checking the antibody to cyclic citrullinated peptide, ultrasound scans, and joint MRIs, for instance. Management strives to suppress inflammation early and as much as possible using disease modifying drugs like methotrexate and tumor necrosis factor (anti-TNF) or even newer drugs such as  abatacept, anakinra, rituximab, or tocilizumab. Complications of RA such as cardiovascular disease and osteoporosis are now better recognized while the use of non-steroidal anti-inflammatory drugs is declining because of worries about cardiovascular safety. Patients may be started on statins in the interest of reducing RA activity, and bisphosphonates to, hopefully, prevent erosions.

Source: Postgraduate Medical Journal 2010;86:243-250