| Title: |
EULAR definition of difficult-to-treat rheumatoid arthritis |
| Authors: |
Nagy, G.; Roodenrijs, N.M.; Welsing, P.M.; Kedves, M.; Hamar, A.; van der Goes, M.C.; Kent, A.; Bakkers, M.; Blaas, E.; Senolt, L.; Szekanecz, Z.; Choy, E.; Dougados, M.; Jacobs, J.W.; Geenen, R.; Bijlsma, H.W.; 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.; Leerstoel Geenen; Clinical Psychology (overkoepelend voor heel KP) |
| Publication Year: |
2021 |
| Subject Terms: |
arthritis; immune system diseases; rheumatoid; synovitis; Rheumatology; Immunology and Allergy; Immunology; General Biochemistry,Genetics and Molecular Biology |
| Description: |
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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0003-4967 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/409105 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/409105 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.35E9BD50 |
| Database: |
BASE |