GuidelineAnnals of the rheumatic diseases2022
EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis.
Guideline in Annals of the rheumatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
137 citing papers in PubMed, 9 syntheses or guidelines pooled it, 256 citations in OpenAlex.
- Therapeutic approaches for difficult-to-treat rheumatoid arthritis: a systematic literature review of current evidence.RMD open · 2026Pooled it
- Efficacy and safety of current therapies for difficult-to-treat rheumatoid arthritis: a systematic review and network meta-analysis.Journal of translational medicine · 2024Pooled it
- Remission definitions guiding immunosuppressive therapy in rheumatoid arthritis: which is best fitted for the purpose?RMD open · 2024Pooled it
- Pooled it
- HBV reactivation in patients with rheumatoid arthritis treated with anti-interleukin-6: a systematic review and meta-analysis.Rheumatology (Oxford, England) · 2023Pooled it
- Multibiomarker disease activity score: an objective tool for monitoring rheumatoid arthritis? A systematic review and meta-analysis.Rheumatology (Oxford, England) · 2023Pooled it
- Prevalence of glucocorticoid-induced osteoporosis among rheumatology patients in Africa: a systematic review and meta-analysis.Archives of osteoporosis · 2023Pooled it
- The effects of Tai Chi on physical function and safety in patients with rheumatoid arthritis: A systematic review and meta-analysis.Frontiers in physiology · 2023Pooled it
- Musculoskeletal ultrasound for treating rheumatoid arthritis to target-a systematic literature review.Rheumatology (Oxford, England) · 2022Pooled it
- The effect of mobilization with movement on pain, joint distance, effusion area, and inflammation in rheumatoid arthritis: a double-blind randomized controlled clinical trial.Journal of orthopaedic surgery and research · 2025Trial
- Digital Psychological Intervention for Inflammatory Rheumatic Diseases: A Pilot Randomized Clinical Trial.JAMA network open · 2025Trial
- Cost-utility analysis of longstanding exercise therapy versus usual care in people with rheumatoid arthritis and severe functional limitations.Scandinavian journal of rheumatology · 2025Trial
- Trial
- Resetting immunometabolic set points in autoimmune disease.Journal of translational autoimmunity · 2026Review
- PD-1MedComm · 2026Article
- Review
- Effectiveness and Safety of Biqi Capsules in 2,267 Patients with Rheumatoid Arthritis: A Real-World Clinical Study.Chinese journal of integrative medicine · 2026Article
- Targeting inflammatory and angiogenic responses by small-molecule kinase inhibitors in a 3D macrophage-containing spheroid model of rheumatoid arthritis synovial tissue.Arthritis research & therapy · 2026Article
- Observational
- Underrecognized depressive and anxiety symptoms in inflammatory arthritis: implications for systematic screening using PHQ-9 and GAD-7.Rheumatology international · 2026Observational
77 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
32 authors at 20 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo develop evidence-based European Alliance of Associations for Rheumatology (EULAR) points to consider (PtCs) for the management of difficult-to-treat rheumatoid arthritis (D2T RA).
methodsAn EULAR Task Force was established comprising 34 individuals: 26 rheumatologists, patient partners and rheumatology experienced health professionals. Two systematic literature reviews addressed clinical questions around diagnostic challenges, and pharmacological and non-pharmacological therapeutic strategies in D2T RA. PtCs were formulated based on the identified evidence and expert opinion. Strength of recommendations (SoR, scale A-D: A typically consistent level 1 studies and D level 5 evidence or inconsistent studies) and level of agreement (LoA, scale 0-10: 0 completely disagree and 10 completely agree) of the PtCs were determined by the Task Force members.
resultsTwo overarching principles and 11 PtCs were defined concerning diagnostic confirmation of RA, evaluation of inflammatory disease activity, pharmacological and non-pharmacological interventions, treatment adherence, functional disability, pain, fatigue, goal setting and self-efficacy and the impact of comorbidities. The SoR varied from level C to level D. The mean LoA with the overarching principles and PtCs was generally high (8.4-9.6).
conclusionsThese PtCs for D2T RA can serve as a clinical roadmap to support healthcare professionals and patients to deliver holistic management and more personalised pharmacological and non-pharmacological therapeutic strategies. High-quality evidence was scarce. A research agenda was created to guide future research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.