Rania Al Asmar, MBBS: Multidisciplinary Teams in Treating Rheumatoid Arthritis

Across virtually every field of medicine, more and more a patient’s condition is being assessed and treated by a multidisciplinary team of clinicians. 



With rheumatoid arthritis patients at a predisposed risk of a plethora of comorbidities including cardiovascular disease and diabetes, rheumatologists are often at the forefront of this approach and it can often mean the difference between concomitant conditions being treated or ignored.

During the Clinical Congress of Rheumatology (CCR) West 2019 annual meeting in San Diego, CA, Rania Al Asmar, MBBS, of Marshall University, presented a study examining trends in patients with rheumatoid arthritis who went on to develop coronary artery disease. Asmar’s study, while specific to coronary artery disease is just one example of the importance of multidisciplinary teams for conditions such as rheumatoid arthritis. 



Al Asmar sat down for an interview with MD Magazine® during the meeting to answer questions about her study, but also to discuss her experiences working with cardiologists and other clinicians when attempting to provide the highest level of care to patients.

MD Mag: How important is taking a multidisciplinary approach for the treatment of conditions with serious comorbidities such as rheumatoid arthritis?

Al Asmar: This is particularly important in our area, specifically in West Virginia, where not all the patients have access to cardiologists until they actually have an MI. So, therefore, these patients should be taken care of by their primary care physicians. Probably a dietitian because of the obesity. They need plus minus a rheumatologist, who's initiating and following up the treatment of the RA and very likely same thing happens with a family practice or an internist who would follow that. Most of them, they need physical therapists.

So, you need a big group of people following these patients. The patient will also feel more taken care. therefore in the decision-making you would be more convincing to the patient in terms of making the decisions. Then, if you refer the patients, just because of having early symptoms and signs or evidence of coronary artery disease to a cardiologist that's better than referring them for a CABG. So, the earlier the better this way they can be intervened on early on—especially with the cardiac rehab programs and all of that.

The bariatric clinic, obesity clinic also needs to be involved especially that obesity clinic. Almost every major hospital now or every major outpatient setting does have an obesity clinic. So, that is someone that needs to be involved. There is not a day where in the clinic you do not refer at least 2 patients to the obesity clinic. Whether they are RA-positive or SLE-positive or whatever autoimmune disease they have.