Managing rheumatoid arthritis in the primary care setting

Rheumatoid arthritis (RA) presents a number of challenges to both patients and physicians. Because primary care physicians (PCPs) treat most patients who have musculoskeletal disorders, they have an important role in the management of RA, particularly in early diagnosis and treatment. Familiarity with the use of disease-modifying antirheumatic drugs (DMARDs) and combination DMARDs as the cornerstones of therapy is essential. PCPs are also in the best position to monitor comorbid disease. Given the potentially devastating complications of RA, disease management requires a comprehensive approach that includes referrals of patients with significant disease comorbidity to rheumatologic specialists.