Competing Interests: Competing interests: TN discloses consulting fees from Novartis, Pfizer, Lilly and Regeneron. JS discloses grant support from the NIH/NIAMS and Rheumatology Research Foundation. MBB discloses grant support from the Rheumatology Research Foundation, Mitsubishi, Corbus, Cumberland and Genentech, honorarium from Elsevier/Practice Update, participation on a data safety monitoring board for Novartis, leadership roles in the American College of Rheumatology and American Board of Internal Medicine, and stock in Johnson and Johnson. YCL discloses grant support from the NIH/NIAMS and Rheumatology Research Foundation, and Pfizer, stock ownership in Cigna-Express Scripts, and receipt of medical writing services from Eli Lilly and Sanofi Genzyme. The remainder of the authors have no relevant competing interests.