Genicular Artery Embolization in Rheumatoid Arthritis

Pathophysiologic Considerations

• In rheumatoid arthritis, synovial inflammation is systemic, immune-mediated, and requires disease-modifying antirheumatic drugs (DMARDs) as the cornerstone of treatment 1, 2

RA Management Framework

• The American College of Rheumatology recommends treating rheumatoid arthritis with DMARDs and following a treat-to-target management strategy 1, 2
• Optimum RA treatment outcomes are achieved through interprofessional teams providing expert patient-centered care 1

Clinical Decision Algorithm

• The American College of Rheumatology guidelines suggest ensuring optimal DMARD therapy before considering other interventions, such as genicular artery embolization, for an RA patient with knee pain 1, 3
• If RA disease activity is active, the American College of Rheumatology guidelines recommend escalating immunosuppressive therapy rather than pursuing procedural interventions 1, 3

Safety Considerations Specific to RA

• RA patients have increased cardiovascular risk requiring proactive management, according to the European Society of Cardiology 4, 5
• RA patients may have cervical spine instability and positioning considerations, as noted by the American College of Rheumatology 6, 7