Rheumatoid Arthritis. Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011

Similar documents
Patient #1. Rheumatoid Arthritis. Rheumatoid Arthritis. 45 y/o female Morning stiffness in her joints >1 hour

When is it Rheumatoid Arthritis When to Refer

Kelley's Textbook of Rheumatology. 2 Volume Set. Text with Internet Access Code for Premium Consult Edition

Etiology: Pathogenesis Clinical manifestation Investigation Treatment Prognosis

Understanding Rheumatoid Arthritis

Rheumatoid arthritis and Psoriatic arthritis: a guide for Primary Care. Nina Flavin, MD Rheumatology Confluence Health April 13 th, 2018

RHEUMATOLOGY OVERVIEW. Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center

Rheumatoid arthritis

Mary Derlacki, FNP. No financial relationships to disclose. Office Rheumatology for the Nurse Practitioner. Rheumatoid Arthritis

Types of osteoarthritis

Rheumatoid Arthritis

REFERRAL GUIDELINES: RHEUMATOLOGY

Essential Rheumatology. Dr Ellen Bruce Consultant Rheumatologist CMFT

Objectives. Joint Pain. Case 1. Rheumatology for the Primary MD (Not just your grandmother s disease) 12/4/2010

Clinical Policy: Tocilizumab (Actemra) Reference Number: ERX.SPMN.44

JuvenileIdiopathicArthritis. Dr Johan Siebert

Rheumatoid Arthritis

Coverage Criteria: Express Scripts, Inc. monograph dated 12/15/ months or as otherwise noted by indication

Rheumatology Review Update in Internal Medicine COPYRIGHT. Robert H. Shmerling, M.D. Beth Israel Deaconess Medical Center.

EARLY INFLAMMATORY ARTHRITIS. Cristina Tacu Consultant Rheumatologist Brighton and Sussex University Hospital

Mr. OA: Case Presentation

Differential Diagnosis And Tests Of Rheumatoid Arthritis And Its Implication For Physiotherapy

Inflammatory rheumatic diseases

Rheumatology Cases for the Internist

Introduction. Rheumatoid Arthritis. Rheumatoid Arthritis. Arthritis vs Rheumatoid Arthritis

Rheumatoid Arthritis. Manish Relan, MD FACP RhMSUS Arthritis & Rheumatology Care Center. Jacksonville, FL (904)

Arthritis. that affects the joints.

Rheumatoid Arthritis

CIBMTR Center Number: CIBMTR Recipient ID: RETIRED. Today s Date: Date of HSCT for which this form is being completed:

2017 Blue Cross and Blue Shield of Louisiana

ERROR CORRECTION FORM

1.0 Abstract. Title. Keywords. Rationale and Background

Index. Note: Page numbers of article titles are in boldface type.

axial spondyloarthritis including ankylosing spondylitis

Remicade (Infliximab)

Seronegative Arthritis. Dr Mary Gayed 25 th April 2018

Understanding Rheumatoid Arthritis

APPROACH TO PATIENTS WITH POLYARTHRALGIA

Case reports CASE 1. A 67-year-old white man had back pain since the age. our clinic several years later with progressive symptoms.

Clinical Policy: Etanercept (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid

AUTOIMMUNITY CLINICAL CORRELATES

AUTOIMMUNITY TOLERANCE TO SELF

Why is this important for you? Types of arthritis. Information for the public Published: 28 February 2017 nice.org.uk

JIA and Other Rheumatic Diseases in Children. Norma Liburd, RN-BC, MN

Horizon Scanning Technology Summary. Adalimumab (Humira) for juvenile idiopathic arthritis. National Horizon Scanning Centre.

APPLICATION FOR SUBSIDY BY SPECIAL AUTHORITY

See Important Reminder at the end of this policy for important regulatory and legal information.

A Patient s Guide to Psoriatic Arthritis

APPLICATION FOR SUBSIDY BY SPECIAL AUTHORITY

Undifferentiated Connective Tissue Disease and Overlap Syndromes. Mark S. Box, MD

BSR Biologics Register Rheumatoid Arthritis Clinical Baseline Form

Clinical Policy: Certolizumab (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid

Gender differences in effectiveness of treatment in rheumatic diseases

Juvenile Idiopathic Arthritis (JIA)

2017 Blue Cross and Blue Shield of Louisiana

A Patient s Guide to. Treatments for Psoriatic Arthritis

Using ENBREL to Treat Rheumatoid and Psoriatic Arthritis

Dr. Lyubomir Marinchev Chief of Rheumatology Department, MHAT SOFIAMED, Sofia, Bulgaria

Musculoskeletal Referral Guidelines

Subject: Remicade (Page 1 of 5)

p. 70 p. 94 p. 102 p. 105 p. 108

First Presentation of Joint Pain


Elements for a Public Summary

Rheumatoid Arthritis. By: Hadi Esmaily (PharmD., BCCP, MBA) Department of Clinical Pharmacy, Shahid Beheshti Medical University

Joint Injuries and Disorders

10/25/2018. Autoimmunity and how to treat it. Disclosure. Why do we get autoimmunity? James Verbsky MD/PhD Pediatric Rheumatology/Immunology

EXAMINING THE CRUCIAL COALITION BETWEEN DERMATOLOGY AND RHEUMATOLOGY IN PSORIATIC ARTHRITIS

Appendix 1: Frequently Asked Questions

Study of Bone Mineral Density (BMD) in Patients with Rheumatoid Arthritis and its Corelation with Severity of the Disease

Arthritis among Patients Attending GMC Hospital, Ajman, UAE: A cross sectional survey

Psoriatic Arthritis- Second Line Treatments

Rheumatoid Arthritis Fact Sheet

Medical Management of Rheumatoid Arthritis (RA)

Certolizumab pegol (Cimzia) for psoriatic arthritis second line

Erelzi (etanercept) Frequently Asked Questions

Rheumatoid Arthritis. Rheumatoid Arthritis. RCS 6080 Medical and Psychosocial Aspects of Rehabilitation Counseling. Rheumatic Diseases

Psoriatic Arthritis Shared Decision Making

Rheumatology and Internal Diseases Clinic of the Central Clinical Hospital in Warsaw 137 Woloska St. WARSAW POLAND prof. Małgorzata Wisłowska

Lahey Clinic Internal Medicine Residency Program: Curriculum for Rheumatology

Aches and Pains in Rheumatology: Is it Fibromyalgia, Osteoarthritis, or Rheumatoid Disease?

Understanding Arthritis. Training

A Patient s Guide to Rheumatoid Arthritis

Palindromic rheumatism

Horizon Scanning Technology Summary. Abatacept (Orencia) for juvenile idiopathic arthritis. National Horizon Scanning Centre.

Topics in Disability. Case Studies

1/3/2008. Karen Burke Priscilla LeMone Elaine Mohn-Brown. Medical-Surgical Nursing Care, 2e Karen Burke, Priscilla LeMone, and Elaine Mohn-Brown

Pain or stiffness in joints after periods of inactivity or excessive use

Articular disease of the hand - the target joint approach

Ad-Hoc Rheumatology Subcommittee of PTAC meeting held 8 March. (minutes for web publishing)

To help you with terms and abbreviations used in this document that may be unfamiliar to you, a glossary is provided on the last pages.

A SURVEY ON RHEUMATOID ARTHRITIS

Abatacept (Orencia) for active rheumatoid arthritis. August 2009

Jeopardy. What s the rash? $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400

Cell-Mediated Immunity and T Lymphocytes

Rheumatology Updates for the Primary Care Provider

Risk Management Plan Etoricoxib film-coated tablets

Department of Paediatrics Clinical Guideline

Transcription:

Rheumatoid Arthritis Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011 The security of experience. The power of innovation. www.rgare.com

Case Study 28 Year Old Female Non-Smoker Nurse Exam Diagnosed with RA 2004; Two deliveries 10/06 and 8/10 5.7.133; 100/62, 96/62, 92/62 2004 Presented to Rheumatology c/o joint pain and stiffness. She has stiffness about 1to2 hours in the morning and on some days can last all day long. Noticed swelling across her hands, pain in her knees and loss of grip strength. Symptoms began about 1 year ago. Has a strong family history of RA and fibromyalgia. Takes Ibuprofen and Aleve prn. Examination - Noted synovitis involving MCP joints both hands. Pain at the extremes of flexion and extension and her elbows. Range of motion in both shoulders significantly limited. Impression - Likely inflammatory arthritis., most likely RA. Plan X-rays of hands and feet; given prescription for Methotrexate, given a shot of IM Medrol to give symptomatic relief while waiting for MTX to kick in. Next year plan to start her on Plaquenil and Sulfasalazine. Was advised to follow up for monitoring to include lab work and eye exam. Throughout 2004 reported variable symptoms and medication adjustments including Prednisone for exacerbations. Noted to be Seropositive for RA including ^CRP and other inflammatory markers. Became pregnant in 2006. Multiple medication adjustments to reduce risk to fetus. RA fairly active through out term.. Successful delivery. After delivery and for the next several years, patient was closely monitored, again with multiple medication adjustments to include a TNF inhibitor such as Enbrel, Humira or Remicade. Continue Plaquenil. Throughout this period never noted to have rheumatoid nodules and medications included both DMARDS and BIO-DMARDS/TNF inhibitors. 6/07 Hgb 13.5; Hct 39.9 Osteopenia diagnosed on bone density scan. Had another successful delivery 2010. Last office visit post delivery bilateral wrist pain, occasionally elbows, shoulders, knees, ankles and feet will swell. Joint pain every day and symptoms are worse in the morning and improve as the day progresses. Managed on Sulfasalazine, Plaquenil, Calcium, Foic acide, Prednisone 10 mg daily and Humira 40 mg subcu every 2 weeks. 2

Rheumatoid Arthritis Inflammatory process Autoimmune disease Systemic 3

Terminology Research Cellular roles CD4 T cells Mononuclear phagocytes Fibroblasts Osteoclasts B Lymphocytes producing autoantibodies/rheumatoid factors Inflammatory mediators Cytokines Chemokines Tumor Necrosis Factor alpha (TNF-alpha) Interleukin (IL-1, IL-6) Transforming growth factor beta Fibroblast growth factor Platelet 4

Defined RA is a systemic autoimmune/ inflammatory disease that leads to synovitis, serositis, rheumatoid nodules and vasculitis 5

Joint Classifications Anatomical Biomechanical Structural Functional 6

Structural Fibrous Cartilaginous Synovial 7

Biomechanical Simple monoarticular Compound oligoarticular Complex polyarticular 8

Typical Joint Synovium Cartilage Tissues 9

Types of Joint Involvement Symmetrical Asymmetrical 10

Sensitivity & Specificity Sensitivity: % of people with disease testing positive (+) Specificity: % of people without disease testing negative (-) 4 subgroups: True Positive (TP) False Positive (FP) True Negative (TN) False Negative (FN) Sensitivity TP/TP+FN Specificity = TN/TN+FP 11

Symptoms Pain Inflammation Systemic involvement 12

Diagnosis Clinical symptoms Imaging Labs Classification criteria by medical consensus 13

Imaging X-rays CT s MRI s 14

Labs 15

Labs C-reactive Protein (CRP) Erythrocyte sedimentation rate Rheumatoid factor Cyclic Citrullinated Peptide (CCP) Antinuclear antibody Synovial fluid 16

Disease Criteria In 2010, American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) established classification criteria system with values between 1 and 10 Every patient with a point total of 6 or higher is unequivocally classified as an RA patient, provided that person has synovitis in at least one joint with no other diagnostic explanation 17

Prevalence Gender Genetic link Age 18

Characteristics Involves peripheral joints Symmetrical in distribution Relapsing/remitting or rapidly progressive Extra-articular manifestations are common Skin nodules over pressure points are common 19

Additional Descriptive Features Temporal pattern Progressive Additive Migratory Axial Peripheral 20

Associative Links to RA Trauma Infection Chemical agents (Agent Orange) Abnormal metabolism Inheritance Immunological factors 21

Morbidity Obesity Occupational hazards Smoking 45 years of age or older Female Prior injuries Hereditary conditions 22

Treatments Analgesics Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) Steroids Disease Modifying Anti-rheumatic Drugs (DMARDS) Biologic DMARDS 23

Other Treatments Antibiotics Hot/cold packs Rest of affected joints Braces or other mobility assistance devices Lifestyle modification Occupational therapy Surgery Alternative therapies 24

Underwriting/Prognosis/Mortality Degree of disability Effects of treatment Systemic involvement Co-morbid conditions Number and degree of positive serologic test 25

Other Forms of Arthritis Osteoarthritis Osteoporosis Gouty arthritis Ankylosing spondylitis Systemic Lupus Erythematosus (SLE) Scleroderma Mixed Connective Tissue Disease (CTD) and undifferentiated CTD Psoriatic arthritis 26

Underwriting Tips Degree of disability Treatment Systemic involvement Co-morbid conditions Number and degree of positive serologic tests Medical reports/musculoskeletal questionnaires Insurance product sought 27

Case Study 28 Year Old Female Non-Smoker Nurse Exam Diagnosed with RA 2004; Two deliveries 10/06 and 8/10 5.7.133; 100/62, 96/62, 92/62 2004 Presented to Rheumatology c/o joint pain and stiffness. She has stiffness about 1to2 hours in the morning and on some days can last all day long. Noticed swelling across her hands, pain in her knees and loss of grip strength. Symptoms began about 1 year ago. Has a strong family history of RA and fibromyalgia. Takes Ibuprofen and Aleve prn. Examination - Noted synovitis involving MCP joints both hands. Pain at the extremes of flexion and extension and her elbows. Range of motion in both shoulders significantly limited. Impression - Likely inflammatory arthritis., most likely RA. Plan X-rays of hands and feet; given prescription for Methotrexate, given a shot of IM Medrol to give symptomatic relief while waiting for MTX to kick in. Next year plan to start her on Plaquenil and Sulfasalazine. Was advised to follow up for monitoring to include lab work and eye exam. Throughout 2004 reported variable symptoms and medication adjustments including Prednisone for exacerbations. Noted to be Seropositive for RA including ^CRP and other inflammatory markers. Became pregnant in 2006. Multiple medication adjustments to reduce risk to fetus. RA fairly active through out term.. Successful delivery. After delivery and for the next several years, patient was closely monitored, again with multiple medication adjustments to include a TNF inhibitor such as Enbrel, Humira or Remicade. Continue Plaquenil. Throughout this period never noted to have rheumatoid nodules and medications included both DMARDS and BIO-DMARDS/TNF inhibitors. 6/07 Hgb 13.5; Hct 39.9 Osteopenia diagnosed on bone density scan. Had another successful delivery 2010. Last office visit post delivery bilateral wrist pain, occasionally elbows, shoulders, knees, ankles and feet will swell. Joint pain every day and symptoms are worse in the morning and improve as the day progresses. Managed on Sulfasalazine, Plaquenil, Calcium, Foic acide, Prednisone 10 mg daily and Humira 40 mg subcu every 2 weeks. 28

Rheumatoid Arthritis Marge Beckman FALU, FLMI Vice President RGA Underwriting Quarterly Underwriting Meeting March 24, 2011 The security of experience. The power of innovation. www.rgare.com