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What is rheumatoid arthritis?

According to the Centers for Disease Control and Prevention (CDC), Rheumatoid Arthritis (RA), an autoimmune condition, is a chronic inflammatory polyarthritis (arthritis that affects five or more joints). An estimated 1.5 million adults in the United States are afflicted with Rheumatoid Arthritis.

RA is a systemic inflammatory disease which manifests itself in multiple joints of the body. The inflammatory process primarily affects the lining of the joints (synovial membrane), but can also affect other organs. The inflamed synovium leads to erosions of the cartilage and bone and sometimes joint deformity. Pain, swelling, and redness are common joint manifestations. Although the causes are unknown, RA is believed to be the result of a faulty immune response. RA can begin at any age and is associated with fatigue and prolonged stiffness after rest.

RA follows three (3) courses:
  • Monocyclic – Have one episode which ends within 2-5 years of initial diagnosis and did not reoccur. This may result from early diagnosis and/or aggressive treatment.
  • Polycyclic – The levels of disease activity fluctuate over the course of the condition.
  • Progressive – RA continues to increase in severity and is unremitting.


The CDC reports data that indicates in 1995-2007, 41 out of 100,000 people were diagnosed with RA each year. Incidence rose with age and peaked among people ages 65-74 years.

What causes rheumatoid arthritis?

According to the CDC, the cause of RA is unknown. Many cases are believed to result from an interaction between genetic factors and environmental exposures.

These are the most common risk factors for RA:
  • Socio-Demographics
  • Genetics
  • Smoking
  • Oral Contraceptives (OC) – Modest to moderate decrease in risk of RA
  • Hormone Replacement Therapy (HRT) – Evidence of a link with using HRT and the onset of RA
  • Live Birth History – Studies show an increased risk if a woman has never had a live birth
  • Breastfeeding – Recent population-based studies have found that RA is less common among women who breastfeed
  • Menstrual History – Women with irregular menstrual cycles or early menopause have an increased risk of RA. Women with polycystic ovarian syndrome (PCOS) have an increased risk of RA

What to expect?

To prevent and/or control joint damage, loss of function and have successful pain management, several approaches should be utilized including medication.

They are:
  • Physical Therapy
  • Occupational Therapy
  • Exercise

How is rheumatoid arthritis treated?

In the past, treatment started with corticosteroids/non-steroidal anti-inflammatory drugs (NSAIDs). Patients who do not respond well to NSAIDs may be moved to non-biologic disease-modifying antirheumatic drugs (DMARDs). Patients who do not respond well to, or show little benefit from, NSAIDS or non-biologic DMARDs may eventually be moved to biologic DMARDs

How a specialty pharmacy can help?

Kroger Specialty Pharmacy sets a clear path to caring, compassionate RA therapy management and support.

We are able to provide RA patients, providers and partners with the necessary coordination of care vital to achieving successful treatment outcomes. By utilizing our expert patient care team comprised of Doctors of Pharmacy, registered pharmacists and nurses, reimbursement specialists and dedicated Patient Care Coordinators (PCCs), we are able to offer each and every patient and partner with high-quality, personalized care, ongoing patient evaluation and clinical support including frequent patient follow-up and continual education about their RA treatment.

Our RA management and support success:
  • Specialty Products – We really make the process of obtaining RA medications easier and more streamlined.y
  • Personalized Guidance – We proactively call patients to make sure they are taking their medication correctly and to answer any concerns they may have.
  • Unmatched Expertise – Our clinical team has a broad and deep understanding of RA specialty products and the coordination of care related to innovative new drugs.
  • Improved Outcomes – Our commitment to better clinical care plus better cost savings yields better adherence rates, insurance approvals, copay assistance, and prior authorizations.