Journal article
Authors list: Roodenrijs, Nadia M. T.; de Hair, Maria J. H.; van der Goes, Marlies C.; Jacobs, Johannes W. G.; Welsing, Paco M. J.; van der Heijde, Desiree; Aletaha, Daniel; Dougados, Maxime; Hyrich, Kimme L.; McInnes, Iain B.; Mueller-Ladner, Ulf; Senolt, Ladislav; Szekanecz, Zoltan; van Laar, Jacob M.; Nagy, Gyorgy
Publication year: 2018
Pages: 1705-1709
Journal: Annals of the Rheumatic Diseases
Volume number: 77
Issue number: 12
ISSN: 0003-4967
eISSN: 1468-2060
Open access status: Green
DOI Link: https://doi.org/10.1136/annrheumdis-2018-213687
Publisher: Elsevier
Objectives Patients with difficult-to-treat rheumatoid arthritis (RA) remain symptomatic despite treatment according to current European League Against Rheumatism (EULAR) management recommendations. These focus on early phases of the disease and pharmacological management. We aimed to identify characteristics of difficult-to-treat RA and issues to be addressed in its workup and management that are not covered by current management recommendations. Methods An international survey was conducted among rheumatologists with multiple-choice questions on disease characteristics of difficult-to-treat RA. Using open questions, additional items to be addressed and items missing in current management recommendations were identified. Results 410 respondents completed the survey: 50% selected disease activity score assessing 28 joints >3.2 OR presence of signs suggestive of active disease as characteristics of difficult-to-treat RA; 42% selected fatigue; 48% selected failure to >= 2 conventional synthetic disease-modifying antirheumatic drugs (DMARDs) AND >= 2 biological/targeted synthetic DMARDs; 89% selected inability to taper glucocorticoids below 5 mg or 10 mg prednisone equivalent daily. Interfering comorbidities, extra-articular manifestations and polypharmacy were identified as important issues missing in current management recommendations. Conclusions There is wide variation in concepts of difficult-to-treat RA. Several important issues regarding these patients are not addressed by current EULAR recommendations.
Abstract:
Citation Styles
Harvard Citation style: Roodenrijs, N., de Hair, M., van der Goes, M., Jacobs, J., Welsing, P., van der Heijde, D., et al. (2018) Characteristics of difficult-to-treat rheumatoid arthritis: results of an international survey, Annals of the Rheumatic Diseases, 77(12), pp. 1705-1709. https://doi.org/10.1136/annrheumdis-2018-213687
APA Citation style: Roodenrijs, N., de Hair, M., van der Goes, M., Jacobs, J., Welsing, P., van der Heijde, D., Aletaha, D., Dougados, M., Hyrich, K., McInnes, I., Mueller-Ladner, U., Senolt, L., Szekanecz, Z., van Laar, J., & Nagy, G. (2018). Characteristics of difficult-to-treat rheumatoid arthritis: results of an international survey. Annals of the Rheumatic Diseases. 77(12), 1705-1709. https://doi.org/10.1136/annrheumdis-2018-213687
