Review of rheumatoid arthritis for the pharmacist

Rheumatoid arthritis (RA) is a chronic disease affecting up to 1% of populations in developed countries. Certain genetic and environmental factors appear to promote the development of RA, but patients can present with heterogeneous signs and symptoms. The goals of any treatment for RA are the reduction of inflammation and remission of disease. Historic treatments, such as aspirin and colloidal gold, were inadequate and did not affect the course of RA. In current practice, there are several biological and synthetic disease-modifying antirheumatic drugs that can reduce disease severity. Guidelines provide point systems for disease classification, stepwise algorithms for treatment, and recommendations for follow-up and monitoring based on response and comorbidities. As RA is a long-term condition, pharmacists can work together with providers to ensure proper drug dosing, titration, and monitoring.