https://m2.mtmt.hu/ hun 2026-05-25 00:43 JournalArticle 31837392 APPROVED IMPORT_WITH_ERROR true Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands Rheumatology, Bacs-Kiskun Megyei Korhaz, Kecskemet, Hungary Rheumatology, University of Debrecen, Debrecen, Hungary Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary Genetics, Cell and Immunobiology, Semmelweis University, Budapest, Hungary Rheumatology, Leiden University Medical Center, Leiden, Netherlands Cited By :15 Export Date: 22 June 2024 Correspondence Address: Roodenrijs, N.M.T.; Rheumatology and Clinical Immunology, Netherlands; email: n.m.t.roodenrijs@umcutrecht.nl 0 false 2026-05-20T13:41:04.060+0000 2026-01-22T15:48:35.581+0000 2021-01-30T12:55:36.667+0000 true 10015206 Áncsán Gizella /api/admin/10015206 Admin true 10015206 2026-03-03T11:51:31.853+0000 2026-03-03T11:51:31.853+0000 true false true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle true 1134514 Survey paper true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle /api/subtype/1134514 Összefoglaló cikk SubType 102 true 1134514 true 1 /api/category/1 Category true 1 Roodenrijs, Nadia M T Diagnostic issues in difficult-to-treat rheumatoid arthritis: a systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis true true /api/journal/10055729 REVIEWED true false 10055729 false 10055729 true 2056-5933 2056-5933 Journal FOREIGN 7 1 e001511 e001511 16 2021 Objectives To summarise the evidence on diagnostic issues in difficult-to-treat rheumatoid arthritis (D2T RA) informing the EULAR recommendations for the management of D2T RA. Methods A systematic literature review (SLR) was performed regarding the optimal confirmation of a diagnosis of rheumatoid arthritis (RA) and of mimicking diseases and the assessment of inflammatory disease activity. PubMed and Embase databases were searched up to December 2019. Relevant papers were selected and appraised. Results Eighty-two papers were selected for detailed assessment. The identified evidence had several limitations: (1) no studies were found including D2T RA patients specifically, and only the minority of studies included RA patients in whom there was explicit doubt about the diagnosis of RA or presence of inflammatory activity; (2) mostly only correlations were reported, not directly useful to evaluate the accuracy of detecting inflammatory activity in clinical practice; (3) heterogeneous, and often suboptimal, reference standards were used and (4) (thus) only very few studies had a low risk of bias. To ascertain a diagnosis of RA or relevant mimicking disease, no diagnostic test with sufficient validity and accuracy was identified. To ascertain inflammatory activity in patients with RA in general and in those with obesity and fibromyalgia, ultrasonography (US) was studied most extensively and was found to be the most promising diagnostic test. Conclusions This SLR highlights the scarcity of high-quality studies regarding diagnostic issues in D2T RA. No diagnostic tests with sufficient validity and accuracy were found to confirm nor exclude the diagnosis of RA nor its mimicking diseases in D2T RA patients. Despite the lack of high-quality direct evidence, US may have an additional value to assess the presence of inflammatory activity in D2T RA patients, including those with concomitant obesity or fibromyalgia. true true 2021 true true true false true false GOLD 2026-05-20 true https://doi.org/10.1136/rmdopen-2020-001511 41 0 41 35 4 41 39 35 39 41 41 35 35 35 6 0 41 35 41 35 0 6 6 Folyóiratcikk Journal Article 24 39 Könyvrészlet Chapter in Book 25 2 Könyv Book 23 0 Egyéb konferenciaközlemény Conference paper 31 0 Egyéb konferenciakötet Conference proceedings 32 0 Oltalmi formák Protection forms 26 0 Disszertáció Thesis 28 0 Egyéb Miscellaneous 29 0 Alkotás Achievement 22 0 Kutatási adat Research data 33 0 Folyóiratcikk Journal Article 24 0 0 0 Könyvrészlet Chapter in Book 25 0 0 0 Könyv Book 23 0 0 0 Egyéb konferenciaközlemény Conference paper 31 0 0 0 Egyéb konferenciakötet Conference proceedings 32 0 0 0 Oltalmi formák Protection forms 26 0 0 0 Disszertáció Thesis 28 0 0 0 Egyéb Miscellaneous 29 0 0 0 Alkotás Achievement 22 0 0 0 Kutatási adat Research data 33 0 0 0 2021 0 2 1 2 1 2022 0 6 5 6 5 2023 0 7 6 7 6 2024 0 10 10 10 10 2025 0 10 9 10 9 2026 0 6 4 6 4 D1 false false false false 2021-01-29T13:11:33.854+0000 Genetikai, Sejt- és Immunbiológiai Intézet (SE / AOK / I); Reumatológiai Tanszék (DE / ÁOK / BelgyI); Reumatológiai és Klinikai Immunológiai Tanszék (SE / AOK / K / BOK) 3 24 3 7 0 true Language 10002 /api/language/10002 Angol English true 2 true PersonAuthorship 95292527 /api/authorship/95292527 1 0.14285715 true false true Roodenrijs Nadia M T true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292528 /api/authorship/95292528 2 0.14285715 false false false Author 10094727 /api/author/10094727 Kedves Melinda true true Kedves Melinda true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292529 /api/authorship/95292529 3 0.14285715 false false false Author 10057639 /api/author/10057639 Hamar Attila true 10057639 true Hamar Attila true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292530 /api/authorship/95292530 4 0.143 false false false Author 10025749 /api/author/10025749 Nagy György true 10025749 true Nagy György true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292531 /api/authorship/95292531 5 0.14285715 false false false van Laar Jacob M true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292532 /api/authorship/95292532 6 0.14285715 false false false van der Heijde Désirée true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95292533 /api/authorship/95292533 7 0.14285715 false true false Welsing Paco M J true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PublicationIdentifier 18346601 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3375021 /api/reference/3375021 116 10.1007/BF02230330 false true Reference 3375022 /api/reference/3375022 117 10.1136/ard.2007.079947 false true Reference 3375023 /api/reference/3375023 118 false true Reference 3375024 /api/reference/3375024 119 10.3899/jrheum.100594 false true /api/publication/31837392 <div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" >Roodenrijs Nadia M T ✉ </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10094727"><a href="/gui2/?type=authors&mode=browse&sel=10094727" target="_blank">Kedves Melinda (<span class="authorship-author-name">Kedves Melinda</span> <span class="authorAux-mtmt"> Reumatológia</span>) </a> </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10057639"><a href="/gui2/?type=authors&mode=browse&sel=10057639" target="_blank">Hamar Attila (<span class="authorship-author-name">Hamar Attila</span> <span class="authorAux-mtmt"> általános orvos</span>) </a> </span> <span class="author-affil"><span title="Debreceni Egyetem">DE</span>/<span title="Általános Orvostudományi Kar">ÁOK</span>/<span title="Belgyógyászati Intézet">BelgyI</span>/Reumatológiai Tanszék</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10025749"><a href="/gui2/?type=authors&mode=browse&sel=10025749" target="_blank">Nagy György (<span class="authorship-author-name">Nagy György</span> <span class="authorAux-mtmt"> Immunológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Intézet">I</span>/Genetikai, Sejt- és Immunbiológiai Intézet; <span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/<span title="Belgyógyászati és Onkológiai Klinika">BOK</span>/Reumatológiai és Klinikai Immunológiai Tanszék</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >van Laar Jacob M </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >van der Heijde Désirée </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Welsing Paco M J </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse&params=publication;31837392" target="_blank">Diagnostic issues in difficult-to-treat rheumatoid arthritis: a systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis</a></div> <div> <span class="journal-title">RMD OPEN</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/2056-5933">2056-5933</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/2056-5933">2056-5933</a>)</span>: <span class="journal-volume">7</span> <span class="journal-issue">1</span> <span class="page"> Paper e001511. 16 p. </span> <span class="year">(2021)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_GOLD" title=" Gold "> <a style="color:blue" title="10.1136/rmdopen-2020-001511" target="_blank" href="https://doi.org/10.1136/rmdopen-2020-001511"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000616713800004" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000616713800004"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="302419" target="_blank" href="http://hdl.handle.net/2437/302419"> DEA </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85100539197" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85100539197"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="33514671" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33514671&dopt=Abstract"> PubMed </a> </span> <span class="id identifier oa_NONE" title=" Nincs "> <a style="color:blue" title="https://rmdopen.bmj.com/lookup/doi/10.1136/rmdopen-2020-001511" target="_blank" href="https://rmdopen.bmj.com/lookup/doi/10.1136/rmdopen-2020-001511"> Egyéb URL </a> </span> </span> <OnlyViewableByAuthor><div class="ratings"> <div class="journal-subject">Folyóirat szakterülete: Scopus - Rheumatology&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Immunology&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;Q1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Immunology and Allergy&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;Q1</div> </div></OnlyViewableByAuthor> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 41</span> | Független: 35 | Függő: 6 | Nem jelölt: 0 | WoS jelölt: 35 | Scopus jelölt:&nbsp;39 | WoS/Scopus jelölt:&nbsp;41 | DOI jelölt:&nbsp;39 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;31837392&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 6 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 31837392</span> | <span class="status-data status-APPROVED"> Nyilvános </span> Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Összefoglaló cikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="errorStatus"> Import hibás </span> | <span class="publication-sourceOfData">kézi felvitel</span> </div> <div class="lastModified">Utolsó módosítás: 2026.01.22. 16:48 Molnár-Taga Márta (SE_AOK_1Bel_Onkol_Admin5_MTM, admin) </div> <pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands Rheumatology, Bacs-Kiskun Megyei Korhaz, Kecskemet, Hungary Rheumatology, University of Debrecen, Debrecen, Hungary Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary Genetics, Ce...</pre> </div></div>