EULAR definition of difficult-To-Treat rheumatoid arthritis

Nagy, G. ✉ [Nagy, György (Immunológia), szerző] III. Sz. Belgyógyászati Klinika (SE / AOK / K); Genetikai, Sejt- és Immunbiológiai Intézet (SE / AOK / I); Reumatológiai és Klinikai Immunológiai Tanszék (SE / AOK / K / ISZBOK); Roodenrijs, N.M.T.; Welsing, P.M.J.; Kedves, M. [Kedves, Melinda (Reumatológia), szerző]; Hamar, A. [Hamar, Attila (általános orvos), szerző] Reumatológiai Tanszék (DE / ÁOK / BelgyI); Van, Der Goes M.C.; Kent, A.; Bakkers, M.; Blaas, E.; Senolt, L.; Szekanecz, Z. [Szekanecz, Zoltán (Reumatológia), szerző] Reumatológiai Tanszék (DE / ÁOK / BelgyI); Choy, E.; Dougados, M.; Jacobs, J.W.G.; Geenen, R.; Bijlsma, H.W.J.; Zink, A.; Aletaha, D.; Schoneveld, L.; Van, Riel P.; Gutermann, L.; Prior, Y.; Nikiphorou, E.; Ferraccioli, G.; Schett, G.; Hyrich, K.L.; Mueller-Ladner, U.; Buch, M.H.; McInnes, I.B.; Van, Der Heijde D.**; Van, Laar J.M.

Angol nyelvű Sokszerzős vagy csoportos szerzőségű szakcikk (Folyóiratcikk) Tudományos
  • SJR Scopus - Biochemistry, Genetics and Molecular Biology (miscellaneous): D1
Background Despite treatment according to the current management recommendations, a significant proportion of patients with rheumatoid arthritis (RA) remain symptomatic. These patients can be considered to have ♭difficult-to-treat RA'. However, uniform terminology and an appropriate definition are lacking. Objective The Task Force in charge of the "Development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis" aims to create recommendations for this underserved patient group. Herein, we present the definition of difficult-to-treat RA, as the first step. Methods The Steering Committee drafted a definition with suggested terminology based on an international survey among rheumatologists. This was discussed and amended by the Task Force, including rheumatologists, nurses, health professionals and patients, at a face-to-face meeting until sufficient agreement was reached (assessed through voting). Results The following three criteria were agreed by all Task Force members as mandatory elements of the definition of difficult-to-treat RA: (1) Treatment according to European League Against Rheumatism (EULAR) recommendation and failure of ?2 biological disease-modifying antirheumatic drugs (DMARDs)/targeted synthetic DMARDs (with different mechanisms of action) after failing conventional synthetic DMARD therapy (unless contraindicated); (2) presence of at least one of the following: at least moderate disease activity; signs and/or symptoms suggestive of active disease; inability to taper glucocorticoid treatment; rapid radiographic progression; RA symptoms that are causing a reduction in quality of life; and (3) the management of signs and/or symptoms is perceived as problematic by the rheumatologist and/or the patient. Conclusions The proposed EULAR definition for difficult-to-treat RA can be used in clinical practice, clinical trials and can form a basis for future research.
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2024-07-21 15:46