2013 Perspectives In Rheumatic Diseases Conference Highlights CME Post Test

1. The concept of treating to target began to emerge as an accepted clinical strategy following publication of:

A. The ACR EULAR classification criteria

B. The ADACTA (ADalamumab ACTemrA) study

C. The Clinical Disease Activity Index (CDAI)

D. The Tight Control for Rheumatoid Arthritis (TICORA) trial

The correct answer is D. The Tight Control for Rheumatoid Arthritis (TICORA) trial. This trial played a significant role in the emergence of the concept of treating to target in clinical practice. The TICORA trial demonstrated that tight control of disease activity in patients with rheumatoid arthritis leads to better outcomes compared to standard care. This finding supported the idea of setting a specific treatment target and adjusting therapy accordingly to achieve optimal disease control. The results of the TICORA trial influenced the development of treatment guidelines and strategies for rheumatoid arthritis management.

Explanation

The correct answer is D. The Tight Control for Rheumatoid Arthritis (TICORA) trial. This trial played a significant role in the emergence of the concept of treating to target in clinical practice. The TICORA trial demonstrated that tight control of disease activity in patients with rheumatoid arthritis leads to better outcomes compared to standard care. This finding supported the idea of setting a specific treatment target and adjusting therapy accordingly to achieve optimal disease control. The results of the TICORA trial influenced the development of treatment guidelines and strategies for rheumatoid arthritis management.

2. The GRAPPA approach has demonstrated that ________ is the class of drugs that has been shown to affect the status of all five domains of psoriatic arthritis.

A. Anti-tumor necrosis factor agents

B. Biologics

C. Interleukins

D. JAK inhibitors

The GRAPPA approach has demonstrated that anti-tumor necrosis factor agents are the class of drugs that has been shown to affect the status of all five domains of psoriatic arthritis. This suggests that these agents have a broad impact on the disease and can effectively target multiple aspects of psoriatic arthritis.

Explanation

The GRAPPA approach has demonstrated that anti-tumor necrosis factor agents are the class of drugs that has been shown to affect the status of all five domains of psoriatic arthritis. This suggests that these agents have a broad impact on the disease and can effectively target multiple aspects of psoriatic arthritis.

3. In patients with psoriasis, numerous studies have demonstrated that tumor necrosis factor inhibitors have demonstrated therapeutic synergy with ________.

A. Interleukin-12/23 inhibitors

B. Methotrexate

C. Systemic corticosteroids

D. Vitamin D analogs

Numerous studies have shown that tumor necrosis factor inhibitors have therapeutic synergy with Methotrexate in patients with psoriasis. Methotrexate is an immunosuppressive medication that helps to reduce inflammation and slow down the growth of skin cells. When used in combination with tumor necrosis factor inhibitors, it can enhance the effectiveness of the treatment and provide better outcomes for patients with psoriasis.

Explanation

Numerous studies have shown that tumor necrosis factor inhibitors have therapeutic synergy with Methotrexate in patients with psoriasis. Methotrexate is an immunosuppressive medication that helps to reduce inflammation and slow down the growth of skin cells. When used in combination with tumor necrosis factor inhibitors, it can enhance the effectiveness of the treatment and provide better outcomes for patients with psoriasis.

4.

More than ___% of patients with rheumatoid arthritis have radiographic abnormalities within 2 years of diagnosis.

60%

70%

80%

90%

Within 2 years of diagnosis, it is reported that more than 90% of patients with rheumatoid arthritis have radiographic abnormalities. This suggests that the majority of individuals with rheumatoid arthritis experience changes in their joints that can be detected through imaging techniques such as X-rays. These abnormalities may include joint erosion, narrowing of joint spaces, and the formation of bone spurs. This high percentage highlights the progressive nature of the disease and the importance of early detection and intervention to prevent further joint damage.

Explanation

Within 2 years of diagnosis, it is reported that more than 90% of patients with rheumatoid arthritis have radiographic abnormalities. This suggests that the majority of individuals with rheumatoid arthritis experience changes in their joints that can be detected through imaging techniques such as X-rays. These abnormalities may include joint erosion, narrowing of joint spaces, and the formation of bone spurs. This high percentage highlights the progressive nature of the disease and the importance of early detection and intervention to prevent further joint damage.

5. According to the ACR/EULAR classification criteria published in 2010, a diagnosis of "definite RA" is indicated by a score of ___ or more out of a possible 10.

2

4

6

8

According to the ACR/EULAR classification criteria published in 2010, a diagnosis of "definite RA" is indicated by a score of 6 or more out of a possible 10.

Explanation

According to the ACR/EULAR classification criteria published in 2010, a diagnosis of "definite RA" is indicated by a score of 6 or more out of a possible 10.

6. Which one of the following assessment tools relies entirely on patient-reported data?

A. Clinical Disease Activity Index (CDAI)

B. Disease Activity Score

C. Routine Assessment of Patient Index Data (RAPID)-3

D. Simplified Disease Activity Index (SDAI)

The correct answer is C. Routine Assessment of Patient Index Data (RAPID)-3. This assessment tool relies entirely on patient-reported data because it is designed to measure the impact of rheumatoid arthritis on patients' physical function, pain, and global health. It does not include any objective measures or clinician assessments.

Explanation

The correct answer is C. Routine Assessment of Patient Index Data (RAPID)-3. This assessment tool relies entirely on patient-reported data because it is designed to measure the impact of rheumatoid arthritis on patients' physical function, pain, and global health. It does not include any objective measures or clinician assessments.

7. The use of TNF inhibitors in ______ is complicated by a lack of supporting data in controlled clinical trials.

A. Elderly patients

B. Patients with comorbid conditions

C. Pediatric patients

D. Psoriasis

The use of TNF inhibitors in pediatric patients is complicated by a lack of supporting data in controlled clinical trials. This means that there is not enough scientific evidence from well-designed studies to determine the safety and effectiveness of TNF inhibitors in treating pediatric patients. Therefore, healthcare providers may be hesitant to prescribe these medications to children due to the lack of data supporting their use in this population.

Explanation

The use of TNF inhibitors in pediatric patients is complicated by a lack of supporting data in controlled clinical trials. This means that there is not enough scientific evidence from well-designed studies to determine the safety and effectiveness of TNF inhibitors in treating pediatric patients. Therefore, healthcare providers may be hesitant to prescribe these medications to children due to the lack of data supporting their use in this population.

8. _____ is the first trial to compare two biologic agents in patients with rheumatoid arthritis who had not responded adequately to methotrexate.

A. The ADACTA study

B. The AMPLE study

C. The MDA study

D. The TICORA trial

The AMPLE study is the first trial to compare two biologic agents in patients with rheumatoid arthritis who had not responded adequately to methotrexate.

Explanation

The AMPLE study is the first trial to compare two biologic agents in patients with rheumatoid arthritis who had not responded adequately to methotrexate.