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Nurse Practitioner:
doi: 10.1097/01.NPR.0000422617.32208.00
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Rheumatoid arthritis: New treatments, better outcomes

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INSTRUCTIONS Rheumatoid arthritis: New treatments, better outcomes

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Rheumatoid arthritis: New treatments, better outcomes

General Purpose: The purpose of this learning activity is to provide information about advances in treating RA. Learning Objectives: After reading this article and taking the test, the learner will be able to: 1. Identify current practice recommendations for treating RA. 2. Discuss new drug therapies for RA.

1. In comparison to previous criteria, the 2010 RA classification criteria

a. reduced sensitivity but improved specificity.

b. improved sensitivity but reduced specificity.

c. improved both sensitivity and specificity.

d. reduced both sensitivity and specificity.

2. For clinical trials, the Boolean-based definition of RA remission includes a C-reactive protein level of

a. ≤ 1.0 mg/dL.

b. ≤ 1.8 mg/dL.

c. ≤ 2.2 mg/dL.

d. ≤ 3.3 mg/dL.

3. Guidelines recommend that to prevent joint damage, appropriate drug therapy should begin within how long after diagnosis?

a. 1 week

b. 1 month

c. 3 months

d. 1 year

4. Using the treat-to-target criteria, how often should medications be adjusted until the target is met?

a. each week

b. each month

c. every 2 months

d. at least every 3 months

5. All of the following indicate potential for a poor prognosis except

a. erosions on radiography.

b. functional limitations.

c. extra-articular disease.

d. need for DMARD therapy.

6. What is the first line of therapy for moderate-to-severe RA?

a. anakinra

b. etanercept

c. infliximab

d. methotrexate

7. According to Finckh and colleagues, evidence for the cost-effectiveness of using biologic agents as an early therapy is

a. inconclusive.

b. significant.

c. highly significant.

d. contradictive.

8. Which FDA-approved drug do the authors not recommend due to limited effectiveness?

a. anakinra

b. etanercept

c. rituximab

d. golimumab

9. Which of the following drugs is an anti-TNF alpha agent?

a. abatacept

b. etanercept

c. rituximab

d. tocilizumab

10. Radstake and colleagues found that some patients who take anti-TNF alpha agents

a. develop serum antibodies to the drug.

b. are at risk for tumor lysis syndrome.

c. are at risk for cardiovascular disease.

d. develop hypercholesterolemia.

11. Which anti-TNF alpha agent has the longest half-life?

a. adalimumab

b. certolizumab pegol

c. golimumab

d. infliximab

12. Tocilizumab is an example of a(an)

a. anti-TNF alpha agent.

b. Beta-cell inhibitor.

c. IL-6 receptor inhibitor.

d. IL-6 agonist.

13. Which drug is a beta-cell inhibitor that has FDA approval for patients who fail to respond well to anti-TNF alpha agents?

a. abatacept

b. certolizumab pegol

c. rituximab

d. tocilizumab

14. Taking certolizumab pegol or golimumab presents a risk of reactivating TB and

a. hepatitis B.

b. hepatitis C.

c. herpes zoster.

d. pulmonary fibrosis.

15. Which of the following is contraindicated during tocilizumab therapy?

a. tuberculin skin testing

b. co-therapy with methotrexate

c. live or attenuated vaccinations

d. treatment with antibiotics

16. The ACR indicates that patients with RA and hepatitis C can be treated with

a. etanercept.

b. golimumab.

c. rituximab.

d. tocilizumab.

17. Before beginning therapy with biologic agents, the ACR recommends screening all patients for

a. latent TB.

b. hepatitis B antibodies.

c. hepatitis C infection.

d. demyelinating diseases.

18. Which score on the ACR/EULAR criteria for RA indicates an RA diagnosis?

a. < 6

b. ≥ 6

c. ≥ 12

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