Early Rheumatoid Arthritis
Conditions
Keywords
pharmacist intervention,, early rheumatoid arthiritis, DAAS 28, utility scoring
Brief summary
Background: Rheumatoid arthritis (RA) is a progressive chronic autoimmune disease with a rising global burden, in which early diagnosis and timely therapeutic intervention are critical to preventing irreversible joint damage and preserving long-term function. Despite established treat-to-target (T2T) frameworks-incorporating conventional, biological, and targeted synthetic disease-modifying antirheumatic drugs (DMARDs) and endorsed by the European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR)-a substantial proportion of patients with early RA fail to achieve the recommended target of DAS28 \<2.6 (remission) or 2.6-3.2 (low disease activity), reflecting persistent gaps in disease management. Pharmacological therapy alone is insufficient: adherence barriers, inadequate disease knowledge, psychosocial distress, unresolved medication-related problems, and suboptimal monitoring continue to undermine outcomes. Clinical pharmacists, whose scope of practice has expanded substantially beyond dispensing to encompass medication optimization, patient education, and behavioral support, represent an underutilized resource in rheumatology care. Purpose: This narrative review synthesizes available evidence on the impact of clinical pharmacist-led interventions on disease activity (DAS28), medication adherence, functional disability, and quality of life (QoL) outcomes in patients with early RA, with particular attention to non-pharmacological mechanisms of effect and the role of adherence as a core mediating outcome.
Interventions
OTHERClinical Pharmacist Led Intervention
Pharmacist intervention will review patient education, Patient education, and counseling
DRUGDMARD Therapy
Scheduled treatment
Sponsors
Deraya University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Adult patients aged 18-65 years. * Diagnosis of early RA according to the 2010 ACR/EULAR classification criteria. * Disease lasts less than 2 years. * Presence of at least one tender and one swollen joint. * Ability to provide informed consent.
Exclusion criteria
* Use of oral glucocorticoids \>10 mg/day during the previous 3 weeks. * Current biological DMARD therapy. * AST or ALT \>3 times the upper limit of normal. * eGFR \<30 mL/min/1.73 m². * Active infection. * Malignancy. * Pregnancy or lactation. * Other autoimmune or musculoskeletal disorders. * Inability to participate in follow-up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Disease activity | 6 months | Measured using the Disease Activity Score in 28 joints (DAS28-ESR |
Countries
Egypt
Outcome results
None listed