The exact role of diet, physical activity, and stress management in the management of RA has long been debated. While reasonable evidence has supported the importance of physical activity in patients with RA, its capacity to reduce disease activity via conventional measures such as DAS28 was less well delineated.

Discussions regarding family planning, contraception, and pregnancy should be approached at each clinic visit to ensure providers understand patients’ personal goals. These conversations have the potential to decrease the risk of unplanned pregnancies. However, rheumatologists may need to manage unplanned pregnancies and the impacts of accidental teratogenic exposure.

Since reduced proteinuria at one year is the best predictor of improved long-term renal outcomes in lupus nephritis, is there rationale to set a tighter treatment target?