Personalized, Interdisciplinary Care Elevates RA Treatment

At present, rheumatoid arthritis (RA) remains an incurable autoimmune condition. However, patients at Cedar-Sinai’s Inflammatory Arthritis Clinical Care Center are finding relief and a renewed quality of life with the help of personalized treatment approaches and multidisciplinary care.1

The center was founded in 2024 with the help of Jon Giles, MD, MPH, associate professor of medicine, Cedars-Sinai, and director of the Inflammatory Arthritis Clinical Center, who came to Cedars-Sinai after more than 10 years at Columbia University. The center not only delivers expert care to patients with RA, but treatment options are also available for patients with spondyloarthropathies, psoriatic arthritis, as well as forms of crystal arthritis, including calcium pyrophosphate deposition disease and gout.

Giles’ research seeks to understand what causes autoimmune disease. His most recent publications on RA have explored the association between multibiomarker disease activity scores and arterial inflammation2 and dispelled the link between estimated glomerular filtration rate and vascular inflammation.3

In honor of National Arthritis Awareness Month in May, Giles spoke with the Cedars-Sinai press office to discuss recent innovations in RA treatment and research. “It may take trying different medications and a bit of time, but I tell patients that we will work together with a goal to get back to their work, their family life and all the things that they like to do, with no limitations,” Giles said in the resulting statement.1

RA results from immune system disfunction, which differentiates the disease from osteoporosis, which results from wear-and-tear over time | image credit: doucefleur - stock.adobe.com

In addition to overseeing patient care, Giles is codirector of the Rheumatoid Arthritis Translational Research Program within Cedars-Sinai’s Kao Autoimmunity Institute. This initiative targets better methods to detect, monitor, and manage the broader health consequences associated with RA. Some severe, and frequently overlooked, risks that spurn from RA include osteoporosis, rapidly progressing cardiovascular disease, and interstitial lung disease.

Giles touched on a common misconception in RA that this condition is an age-related disease. RA tends to develop around age 50, he mentioned; however, in his practice he sees patients of all ages.

He also explained what distinguishes RA from osteoarthritis. Although each condition can impact similar joints, osteoarthritis stems from gradual wear-and-tear damage, which worsens with activity. RA, by contrast, results from immune system dysfunction, with symptoms like joint stiffness typically being most intense in the morning.

Over the last 20 years, treatment options have dramatically improved. “Now, very few patients don’t respond to available therapies,” Giles noted. At Cedars-Sinai, the team utilizes a “treat to target” strategy, adjusting therapies in response to persistent inflammation or if patients don’t achieve remission. This proactive approach helps preserve joint function and supports long-term well-being.

Patients with RA should be checking in with their rheumatologists to complete blood work every 3 to 4 months, Giles added. As patient responses to treatment can vary over time, avoiding a “set it and forget it” approach and staying open minded to switching therapies is essential.

RA care can become more complex when it affects a patient’s lungs, especially in cases of interstitial lung disease, Giles continued. For this reason, Cedars-Sinai takes a multidisciplinary care approach that, for example, coordinates with the Women’s Guild Lung Institute. These collaborations help ensure patients receive the best care possible, particularly because there can be little overlap between lung-treating and joint-treating medications.

On the research front, the Kao Autoimmunity Institute and Lung Institute are working together to understand how to best address interstitial lung disease and RA, and how the 2 develop. There are also extensive screening and treatment efforts being performed to shed more light on the underlying mechanisms of atherosclerosis for those with RA.

“It’s rewarding to be able to say to someone starting treatment, ‘How you feel right now is not how you are going to feel in the future,’” Giles concluded. “Rheumatoid arthritis is a long-term disease that requires ongoing care, giving rheumatologists time to build strong relationships with their patients.”

References

1. Comprehensive care boosts active lifestyle for RA patients. News release. Cedars-Sinai. April 28, 2025. Accessed April 29, 2025. https://www.newswise.com/articles/comprehensive-care-boosts-active-lifestyle-for-ra-patients/?ad2f=1&aid=827538

2. Giles JT, Solomon DH, et al. Association of the multi-biomarker disease activity score with arterial 18-fluorodeoxyglucose uptake in rheumatoid arthritis. Rheumatology. 2025;64(3):1077-1083. doi:10.1093/rheumatology/keae242

3. Fukui S, Tawakol A, Winkelmayer WC, et al. No association between vascular inflammation and estimated glomerular filtration rate in patients with rheumatoid arthritis: secondary analysis of the TARGET trial. Scand J Rheumatol. 2025;54(3):213-216. doi:10.1080/03009742.2025.2455878