Clinical Reflections®: Achieving Success in RA Assessment and Management: A Learner Pathway to Improve Patient Outcomes

Achieving Success in RA Assessment and Management: A Learner Pathway to Improve Patient Outcomes
1 ANCC Contact Hours 1 AMA PRA Category 1 Credit(s)
Launch Date:
October 12, 2017
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:


Relevant Terms:

Rheumatoid Arthritis

Jeffrey R. Curtis, MD, MS, MPH (Chair)

Jeffrey R. Curtis, MD, MS, MPH (Chair)
William J. Koopman Endowed Professor in Rheumatology and Immunology
Professor of Medicine, Division of Clinical Immunology and Rheumatology
Director, University of Alabama at Birmingham (UAB) Arthritis Clinical Intervention Program
Co-Director, UAB Center for Education and Research on Therapeutics (CERTS) of Musculoskeletal Disorders 
Co-Director, UAB Pharmacoepidemiology and Pharmacoeconomics (PEER) Unit
University of Alabama at Birmingham
Birmingham, AL

Dr Jeffrey Curtis is a professor of medicine in the division of clinical immunology and rheumatology at the University of Alabama at Birmingham. Dr Curtis received a medical degree and a Master of Public Health degree from Oregon Health & Science University in Portland, Oregon. He subsequently completed a residency in internal medicine at Oregon Health & Science University and a fellowship in rheumatology at UAB. He completed a graduate program in clinical informatics at Stanford University and received his Master of Science degree in epidemiology at the Harvard School of Public Health. He is board certified in both rheumatology and clinical informatics.
Dr Curtis currently holds the William J. Koopman Endowed Professorship in Rheumatology and Immunology at UAB. He is the co-director of the UAB Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, which has a major emphasis on evaluating the safety and comparative effectiveness of medications for rheumatic diseases. Additionally, as the director of the UAB Arthritis Clinical Intervention Program, he leads the clinical trials unit for the rheumatology division at UAB, with a particular focus on rheumatoid arthritis and psoriatic arthritis. Dr Curtis is the co-director of the UAB Pharmacoepidemiology and Pharmacoeconomics Research (PEER) Unit. PEER uses multiple large data sources to study comparative effectiveness questions across multiple chronic diseases. These data sources include national administrative data from Medicare and commercial health plans, electronic health record data, and large registries. In 2012, Dr Curtis was awarded the Henry Kunkel Young Investigator Award by the American College of Rheumatology (ACR) and was accepted into the American Society for Clinical Investigation (ASCI) in 2016.
The evaluation of the efficacy, comparative effectiveness, and safety of the medications used to treat rheumatoid arthritis and spondyloarthritis are among Dr Curtis’s research interests. He served on the Core Expert Panel for the ACR’s 2008, 2012, and 2015 Recommendations for the Use of Non-Biologic and Biologic Disease Modifying Antirheumatic Drugs in RA. He was the deputy director for a collaborative project between the FDA, the Agency for Healthcare Research and Quality, and a number of academic centers studying the safety of biologic agents using multiple, pooled national data sources. He is the co-principal investigator (PI) of the Patient-Centered Outcomes Research Institute (PCORI)-funded Patient Powered Research Network “Arthritis-Power” registry, which is focused on RA, psoriasis, and psoriatic arthritis. He also leads the multicenter National Institutes of Health (NIH)-funded large, pragmatic, randomized, controlled trial “VERVE,” studying the safety and effectiveness of the live herpes zoster vaccine in patients receiving biologic agents. Dr Curtis is a member of the Center for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) Herpes Zoster workgroup. In 2015, he was appointed as a member to the FDA Arthritis Advisory Committee. Dr Curtis also studies risk factors for and outcomes of osteoporosis. He was a member of the ACR’s task force to update recommendations for the management of glucocorticoid induced osteoporosis. He served on the American Society of Bone and Mineral Research (ASBMR) Task Force on Atypical Subtrochanteric and Diaphyseal Fractures.
Dr Curtis is a member of the American College of Rheumatology, the International Society for Pharmacoepidemiology, the American Medical Informatics Association, and the American Society of Bone and Mineral Research. He has been on the editorial board for Arthritis & Rheumatism, Pharmacoepidemiology and Drug Safety, and Arthritis Care and Research. He has authored more than 300 peer-reviewed manuscripts, review articles, and book chapters.

Martin Jan Bergman, MD, FACR, FACP, FCPP

Martin Jan Bergman, MD, FACR, FACP, FCPP
Clinical Associate Professor of Medicine
Drexel University School of Medicine
Philadelphia, PA
Chief, Division of Rheumatology
Taylor Hospital
Ridley Park, PA

Martin Jan Bergman, MD, FACR, FACP, FCPP, is clinical associate professor of medicine at the Drexel University School of Medicine in Philadelphia. He is also a full-time clinical rheumatologist in a private practice setting, with nearly 30 years of clinical experience.
In addition to issues affecting the running of a successful clinical practice, Dr Bergman is interested in issues facing practicing rheumatologists on a daily basis. With collaborators, Dr Bergman has played a pivotal role in the development of patient management tools, particularly the Routine Assessment of Patient Index Data 3 (RAPID3). This disease measurement tool is now an outcomes measure accepted by the American College of Rheumatology and used worldwide.
Dr Bergman is a recognized leader in the field of clinical and patient reported outcomes, and has spoken both nationally and internationally on this and other topics. For his work, he has received the Joseph L. Hollander Award for Excellence and Achievement in Rheumatology by the Southeast Pennsylvania Arthritis Foundation and has been elected as a fellow of the College of Physicians of Philadelphia.

Peter C. Taylor, MA, BM, BCh, PhD, FRCP, FRCPE

Peter C. Taylor, MA, BM, BCh, PhD, FRCP, FRCPE
Norman Collison Professor of Musculoskeletal Sciences
Fellow, St. Peter’s College
Head of Clinical Sciences, Biomedical Research Unit Inflammation Theme
Botnar Research Centre
University of Oxford
Oxford, England (UK)

Peter C. Taylor, MA, BM, BCh, PhD, FRCP, FRCPE, holds the Norman Collison Chair of Musculoskeletal Sciences at the University of Oxford and is a fellow of St. Peter’s College, Oxford. He is the director of clinical sciences and the biomedical research unit inflammation theme at the Botnar Research Centre and leads the rheumatology clinical trials group within the Nuffield Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences. He was formerly professor of experimental rheumatology at the Kennedy Institute of Rheumatology Division, Imperial College London, and the dean of the Charing Cross campus.
Dr Taylor studied pre-clinical medical sciences at Gonville and Caius College at the University of Cambridge and his first degree was in Physiology. He subsequently studied clinical medicine at the University of Oxford and was awarded a PhD degree from the University of London for studies on pathogenesis of arthritis. In the summer of 2015 he was appointed medical director of the National Rheumatoid Arthritis Society, an outstanding patient led charity that works tirelessly to support patients with rheumatoid arthritis and juvenile inflammatory arthritis. Professor Taylor chairs the UK government and NIHR Translational Research Partnership in rheumatology that brings together the UK's leading academic and clinical centers for experimental medicine and translational research into a ready-formed partnership of Universities and NHS hospitals. He was nominated as a distinguished member of the British Society for rheumatology in 2016.
Dr Taylor has specialist clinical interests in inflammatory arthritis. He has over 20 years’ experience in clinical trial design and international leadership in studies of biologic and small molecular therapies in rheumatoid arthritis and ankylosing spondylitis, including the earliest seminal trials of anti-TNF and anti-IL-6 receptor therapy. His research expertise is in mechanisms sustaining inflammation and clinical trials of new therapies with development of novel outcome measurements for application in assessment of response to therapy including ultrasonographic and high field magnetic resonance imaging technology. In experimental medicine studies, Dr Taylor employs targeted therapies as probes of pathogenesis to investigate the in vivo biology of the target in the pathobiology of the disease phenotype under investigation. His interest in novel outcome measures also includes new tools for the personalized assessment of wellbeing which can be used adjunctively to clinical outcome measures in informing management decisions.
1. Discriminate between the effects of the tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6) signaling pathways in the pathophysiology of rheumatoid arthritis (RA) and provide a rationale for anti-cytokine therapy as a treatment approach
2. Incorporate validated and guideline-recommended disease activity monitoring to guide appropriate management for patients with rheumatoid arthritis
3. Develop individualized treatment plans for patients with rheumatoid arthritis that integrate new and emerging targeted and non-TNF disease modifying antirheumatic drugs (bMARDs) based on safety and efficacy data
4. Distinguish between TNF cycling and switching and prepare treatment plans that improve patient outcomes based on an understanding of the differences between the 2 options
5. Integrate shared decision making and other patient education strategies for patients with rheumatoid arthritis

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and RMEI Medical Education, LLC. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Postgraduate Institute for Medicine is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.  This educational activity for 1 contact hour is provided by the Postgraduate Institute for Medicine. Designated for 0.5 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses.
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
  • Jeffrey R. Curtis, MD, MPH, MS, has affiliations with AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Genentech, Janssen, Lilly, Myriad, and Pfizer (Consulting Fees); and AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Genentech, Janssen, Lilly, Myriad, and Pfizer (Contracted Research).
  • Martin Jan Bergman, MD, FACR, FACP, FCPP, has affiliations with AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Genentech, GlaxoSmithKline, Janssen, Novartis, Pfizer, and Sanofi (Consulting Fees); AbbVie, Celgene, Novartis, and Sanofi (Fees for Non-CME/CE Services Received Directly from a Commercial Interest or Their Agents); Johnson & Johnson, Merck, and Pfizer (Ownership Interest).
  • Peter Taylor, MA, BM, BCh, PhD, FRCP, FRCPE, has affiliations with AbbVie, Biogen, Galapagos, GlaxoSmithKline, Janssen, Lilly, Pfizer, Sanofi, and UCB (Consulting Fees); and Abide Therapeutics, Celgene, Lilly, and UCB (Contracted Research).
RMEI Medical Education, LLC
  • Jacqui Brooks, MBBCh, MRCPsych, has no affiliations with commercial interests to disclose.
  • Tania Dickson, PhD, has no affiliations with commercial interests to disclose.
  • Jessica Hatch has no affiliations with commercial interests to disclose.
Postgraduate Institute for Medicine
The following PIM planners and managers: Judi Smelker-Mitchek, RN, BSN; Trace Hutchison, PharmD; Samantha Mattiucci, PharmD, CHCP; and Jan Schultz, MSN, RN, CHCP, have nothing to disclose.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. 
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Estimated time to complete: 1 hour
Medium: Internet
There is no fee for this educational activity.
This activity is jointly provided by Postgraduate Institute for Medicine and RMEI Medical Education, LLC. This activity is supported by an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals.
By reviewing the course content and successfully completing the post test and evaluation, physicians, nurse practitioners, and PAs are entitled to receive up to 1 AMA PRA Category 1 Credit(s)™, 1 ANCC contact hour, and 0.5 APRN contact hours. A statement of credit will be available to print from your user history page. Users must:
  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the activity evaluation.
Physicians, nurse practitioners, and PAs who successfully complete the post test and evaluation will receive CME credit. You must score 75% or higher on the post test to receive credit for this activity. All other participants who successfully complete the post test and evaluation will receive a certificate of participation.

Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.