No Patient Left Behind: Building the Case for Early RA Therapy
Key Issues in the Management of Patients with Early RA

Medium: eMonograph
Accreditation Expired

Credit Hours

Physician CME: 1.0
Physician Assistants Hours: 1.0

Educational Overview

There has been remarkable progress in the therapy of rheumatoid arthritis (RA), related in part to a better understanding of the pathogenesis of this disease. The development of several effective and safe novel therapeutic options has contributed to a shift in the treatment paradigm that now focuses on early and aggressive management supported by increasing evidence of the clinical and radiographic benefits of initiating DMARD treatment early in the course of the disease. These benefits include a reduction in the risk of associated comorbidities, in particular cardiovascular disease. Clinical remission has become an attainable goal and improved patient quality of life is now an expected outcome. All these developments have made “no patient left behind” a definite possibility.

Against this backdrop, healthcare professionals caring for patients with early RA need to be armed with the latest knowledge about ways in which to individualize therapy to achieve patient-specific goals.

Target Audience

This educational activity has been developed for rheumatologists, pharmacists, and allied health professionals including physician assistants responsible for the management of patients with early RA.

Purpose Statement

The purpose of this activity is to educate rheumatologists, pharmacists, and allied health professionals involved in the management of RA patients on the benefits of aggressive, early RA therapy and patient-centered management to achieve customized goals. With this knowledge, healthcare professionals will be able to tailor therapy to meet patient-specific goals making “no patient left behind” a reality.

Learning Objectives

After completing this educational activity, learners should be able to:

  1. Recognize the benefits of pharmacotherapy for early rheumatoid arthritis (RA), including undifferentiated arthritis
  2. Compare the safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and biologic agents for the treatment of RA
  3. Customize management strategies for early RA patients with comorbidities


Michael H Schiff, MD

Clinical Professor of Medicine, Rheumatology Division
University of Colorado School of Medicine
Denver, CO

Elena M Massarotti, MD

Associate Professor of Medicine, Harvard Medical School
Co-Director, Center for Clinical Therapeutics
Division of Rheumatology
Brigham and Women’s Hospital
Boston, MA



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 joint sponsorship of Center for Independent Healthcare Education (Center) and Vemco MedEd. Center is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: Center designates for this activity a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physician Assistants

American Academy of Physician Assistants accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.0 hour of Category I credit for completing this activity.

Method of Participation and Instructions for Credit

To receive credit for this educational activity, learners must

  1. Review the entire activity and related CME information including target audience, learning objectives, and disclosures.
  2. Print and complete the Self-Assessment, Evaluation, and Credit Application form (pages 22 and 23 in the PDF).
  3. Mail the completed Self-Assessment, Evaluation, and Credit Application form to Vemco MedEd, 245 US Highway 22, Suite 304, Bridgewater, NJ 08807 Or Fax to (908) 450-3300.

Documentation of credit will be mailed within 4 weeks of receipt of the completed Self-Assessment, Evaluation, and Credit Application form.

Disclosure of Conflict of Interest

Center for Independent Healthcare Education requires faculty, planners, and others who are in a position to control the content of continuing education activities to disclose to the audience any real or apparent conflict of interest related to the activity. All identified conflicts of interest are reviewed to ensure fair balance, objectivity, and scientific rigor in all activities. The faculty is further required to disclose discussion of off-label uses in their presentations.



Michael H. Schiff, MD

Advisor/Consultant: Abbott, Amgen, Array BioPharma, Bayer, Bristol-Myers Squibb, Novartis, Roche, and UCB
Promotional speaker’s bureau: Abbott

Elena M. Massarotti, MD

Grant/Research Support: EMD Serono, Genentech, and UCB
Advisor/Consultant: Bristol-Myers Squibb, EMD Serono, Genentech, Pfizer, and UCB

Planning Committee Members

Employees of Center for Independent Healthcare Education and Vemco MedEd have no relevant financial relationships to disclose.

Disclosure of Off-Label Use

During this activity, the following off-label uses of the following antirheumatic agents are discussed: infliximab and abatacept (both for treatment of undifferentiated arthritis). The following investigational agent (as of July 2009) is also discussed: tocilizumab (for treatment of rheumatoid arthritis).

Joint Sponsorship

This activity is jointly sponsored by Center for Independent Healthcare Education and Vemco MedEd.

Commercial Support

This activity is supported by an educational grant from Bristol-Myers Squibb.


There is no fee associated with this educational activity.

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Copyright Statement

Copyright © 2009 Vemco MedEd, LLC. All Rights Reserved.
Permission for accreditation use granted to Center for Independent Healthcare Education.


The opinions expressed in this educational activity are those of the authors and do not reflect the views of Center for Independent Healthcare Education (Center) and Vemco MedEd. This educational activity may discuss off-label and/or investigational uses and dosages for therapeutic products/procedures that have not been approved by the United States Food and Drug Administration (FDA). Center and Vemco MedEd do not recommend the use of any product/procedure outside of the labeled indications. A qualified healthcare professional should be consulted before using any therapeutic product/procedure discussed. Learners should verify all information and data before treating patients or employing any therapies described in this continuing education activity. Please refer to the official prescribing information for each product/procedure for approved indication, contraindications, and warnings.

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Contact Information

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