Difficult-to-treat rheumatoid arthritis: what have we learned and what do we still need to learn?

Autor:	Hofman ZLM; Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands., Roodenrijs NMT; Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands., Nikiphorou E; Centre for Rheumatic Diseases, King's College London, London, UK.; Rheumatology Department, King's College Hospital, London, UK., Kent AL; EULAR patient partner., Nagy G; Department of Rheumatology and Clinical Immunology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.; National Institute of Locomotor Diseases and Disabilities, Budapest, Hungary., Welsing PMJ; Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands., van Laar JM; Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Oct 09. Date of Electronic Publication: 2024 Oct 09.
DOI:	10.1093/rheumatology/keae544
Abstrakt:	Difficult-to-treat rheumatoid arthritis (D2T RA) is an area of high unmet need. The prevalence reported in the first D2T RA cohort studies ranged from 5.5-27.5%. Key to the definition is a conviction by patient and/or rheumatologist that disease management has become problematic and failure of at least two biological or targeted synthetic disease-modifying antirheumatic drugs. D2T RA is a multifactorial disease state which was reflected in data from D2T RA cohort studies: these pointed towards high prevalence of co-morbidities and/or lower socioeconomic status in D2T RA subgroups, while others had persistent symptoms without these factors being present. A holistic approach is necessary to identify the root problems underlying D2T RA in individual patients. In this review, biological and non-biological drivers that should be considered to be optimized will be discussed in view of what we have learned from patient data emerging from the first D2T RA cohort studies. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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