Challenges and insights in managing difficult-to-treat rheumatoid arthritis: real-world clinical perspectives
Authors' conclusion
D2T RA requires more intensive management, and patients with D2T RA have higher disease activity, poorer functional status, and quality of life than those without D2T RA.
Study context
- Population
- Consecutive patients with rheumatoid arthritis (RA) according to the 2010 ACR criteria (mean age 56.5 years, 80.1% female, 75% seropositive)
- Participants
- 302 patients
- Exposure
- Difficult-to-treat (D2T) RA vs non-D2T RA
- D2T RAn = 27
- Outcome
- Frequency of D2T RA (EULAR 2021 definition)
Methodological detailsconsecutive patients, multiple logistic regression
- Consecutive patients
- Multiple logistic regression
Main finding
As reported in the abstract
Frequency of D2T RA
D2T RA
8.9%
27
Observational data: associations, not effects.
Further findings
Characteristics of D2T vs non-D2T RA
- D2T RA: lower age at diagnosis and longer disease duration
- D2T RA: significantly higher rates of peripheral erosion, Sjögren's syndrome, extra-articular manifestations and PtGA-PhGA discordance, with high disease activity scores
- D2T RA: median number of comorbidities and concomitant FM significantly higher
Factors independently associated with D2T RA (multiple regression)
- Higher HAQ-DI, RF levels and concomitant FM independently associated with D2T RA
Original publication
Challenges and insights in managing difficult-to-treat rheumatoid arthritis: real-world clinical perspectives. Clin Exp Rheumatol. Published 17 September 2023. doi:10.
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