Palliative care in advanced systemic rheumatic diseases: an integrated approach

Despite rapid advances in the field of rheumatology, many patients with rheumatoid arthritis suffer from chronic and debilitating systemic disease, with a high symptom burden and limited life expectancy. In this paper, we demonstrate an approach to managing a patient with rheumatoid arthritis with life-limiting illness for the palliative care physician. In particular, we focus on the systemic nature of rheumatoid arthritis and nuances around medication management towards the end of life. It is our hope that this paper can serve as a guide for the palliative care clinician to decrease end-of-life morbidity from rheumatic disease and rheumatic medications.