Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Kauffman, Russell


rheumatoid arthritis, treatment, biologics, tumor necrosis factors, interleukin inhibitors, T-cell inhibitors, B-cell inhibitors, vitamin D


Rheumatoid arthritis (RA) is a chronic inflammatory disease leading to joint destruction. There are several treatment options available to patients, including conventional disease modifying antirheumatic drugs (DMARDS) and biological agents, but their efficacies vary per patient and have significant adverse effects and costs associated. There is, however, encouraging evidence to suggest the incorporation of vitamin D in treatment regimens may be a promising option for patients. A comprehensive literature review was conducted using PubMed and CINHAL databases, employing keywords and MeSH terms related to RA treatment options, with the goal to compare efficacy of biological agents and vitamin D in the symptom management and progression of RA. Eleven studies met criteria and were analyzed. These studies evaluated vitamin D, tumor necrosis factors, interleukin inhibitors, B-cell inhibitors, and T-cell inhibitors in the treatment and prevention of RA progression. The review highlights the complexity of managing RA and underscores the favorable outcomes observed in symptom management and disease progression by biological agents compared to vitamin D. Although vitamin D demonstrates promise as an adjunctive and potential preventative therapy, further research that includes vitamin D as part of a treatment regimen with biologics is necessary to evaluate its potential and proper use in the treatment of RA. Providers must remain informed about optimal practice recommendations, be amenable to a trial-and-error approach to treatment, and consider combination therapy, with use of DMARDS, biologics, and adjunctive therapies such as vitamin D to best meet the needs of individual patients.