Rheumatoid arthritis (RA) is a chronic, inflammatory disease characterized by joint swelling, joint tenderness, and progressive destruction of synovial joints, which can lead to severe disability and premature mortality. Treat-to-target recommendations emphasize the need to commence therapeutic intervention early using disease-modifying antirheumatic drugs (DMARDs) with frequent reassessment and adjustment of treatment to ensure that patients have a chance to achieve the goal of disease remission. However, diagnosis and active therapy for early RA is often delayed, which can have long-term adverse consequences on disease progression.
By providing evidence-based “top 10” pearls to PCPs, rheumatologists can help PCPs to diagnose RA and to be familiar with the available treatment options for RA, as they have to decide whether to initiate treatment or refer the patient to a specialist–but also care for the patient while awaiting a specialist appointment. Chronotherapeutic advances in the treatment of RA can help PCPs to bridge therapy and treat to target. Chronotherapy–which is defined as the judicious timing of conventional or special drug-release therapeutic interventions in order to align drug peak and trough concentrations to specific circadian (~24-hour) rhythm markers of disease activity of medical conditions–is a means to optimize treatment outcomes and potentially minimize or avoid adverse effects (AEs).
Michael H. Smolensky, PhD
Cockrell School of Engineering,
Department of Biomedical Engineering,
The University of Texas at Austin,
American Association of Medical Chronobiology & Chronotherapeutics
Raymond M. Pertusi, DO
Clinical Associate Professor of Medicine/Rheumatology,
University of Massachusetts Medical School,
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This activity is supported by an educational grant from Horizon Pharma.