Management of Rheumatoid Arthritis with Current Treatment Options

Faculty Sponsor

Jana Stedman

College

Nursing

Department/Program

Physician Assistant Program

Presentation Type

Poster Presentation

Symposium Date

Summer 7-26-2023

Abstract

Objective: To analyze if conventional disease-modifying anti-rheumatic drugs (csDMARD) are more effective than biologic disease-modifying anti-rheumatic drugs (bDMARD) in treating rheumatoid arthritis over the course of the disease. Without treatment, rheumatoid arthritis can result in loss of functionality with decreased joint mobility, and physical weakness; highlighting the need for adequate maintenance therapy with either csDMARD or biologic disease-modifying anti-rheumatic drugs. Methods: Used tertiary data extracted from previous literature analysis pertaining to the topic of interest. To determine the best method of maintenance therapy in adults, the Valparaiso University online library catalog was utilized to find peer-reviewed articles regarding each maintenance therapy within the last five years. Filters used during research were ‘peer reviewed journals,’ ‘full text available,’ ‘meta-analysis,’ ‘systematic review,’ and ‘cohort studies. The primary endpoint this research focuses on is whether csDMARDs treat RA disease activity more than bDMARDs. Overall, 58 different journal articles were reviewed with information extracted from 13. Results: Initial therapy started in early disease should be a conventional disease modifying anti-rheumatic drug as overall studies show that 71% of patients had reduced disease activity. Biologic treatment alone should not be used as a monotherapy due to insufficient evidence of efficacy. The highest efficacy of treatment is a combination therapy of conventional and biologic treatment as it leads to smaller radiographic changes, decreased disease activity, and higher remission rates. Conclusion: A combination of a csDMARD and bDMARD has been shown to be the best long-term maintenance therapy for individuals not fully controlled on conventional treatment alone.

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