ArticleRMD open2023
Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease.
Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Clinical characteristics and associated factors of difficult-to-treat rheumatoid arthritis: a cross-sectional study.Clinical rheumatology · 2026Article
- Article
- Clinical and healthcare burden of difficult-to-treat rheumatoid arthritis in Japan: a retrospective cohort study.BMJ open · 2026Observational
- Targeting fibroblasts in immune mediated inflammatory diseases: a cellular basis for cure?Rheumatology (Oxford, England) · 2026Review
- Factors Associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA): Real-World Evidence from a Single-Center Cross-Sectional Study.Journal of personalized medicine · 2026Article
- Predicting the progression of difficult-to-treat rheumatoid arthritis by a machine learning scoring system, from the FIRST registry.RMD open · 2026Article
- Vagus nerve stimulation: a novel approach for refractory rheumatoid arthritis.Clinical rheumatology · 2026Article
- Gut dysbiosis in difficult-to-treat rheumatoid arthritis: hypothesized microbial endotypes, persistent inflammation, and pharmacological treatment resistance.Frontiers in pharmacology · 2026Review
- Early identification of difficult-to-manage axial spondyloarthritis using machine-learning decision trees.Therapeutic advances in musculoskeletal disease · 2026Article
- Multiple DMARD discontinuations in rheumatoid arthritis: how often and in what patients? Results from a national clinical RA register.RMD open · 2025Observational
- Evolution from early to difficult-to-treat rheumatoid arthritis: incidence and risk factors in the ERA uclouvain Brussels cohort.Arthritis research & therapy · 2025Article
- Early-onset difficult-to-treat rheumatoid arthritis: proposal of data-driven predictors and temporal threshold.Arthritis research & therapy · 2025Observational
- Exploring difficult-to-manage axial spondyloarthritis: results from a Dutch clinical practice registry.Rheumatology (Oxford, England) · 2025Article
- Prevalence and characteristics of adults with difficult-to-treat rheumatoid arthritis in a large patient registry.Rheumatology (Oxford, England) · 2025Article
- Rheumatoid Factor: Diagnostic and Prognostic Performance and Therapeutic Implications in Rheumatoid Arthritis.Journal of clinical medicine · 2025Review
- The absolute number of circulating Treg cells is reduced in difficult-to-treat RA patients and is ameliorated by low-dose IL-2.Frontiers in immunology · 2025Article
- Difficult-to-treat rheumatoid arthritis: what have we learned and what do we still need to learn?Rheumatology (Oxford, England) · 2025Review
- Unmet Needs and Current Challenges of Rheumatoid Arthritis: Difficult-to-Treat Rheumatoid Arthritis and Late-Onset Rheumatoid Arthritis.Journal of clinical medicine · 2024Review
- Timely escalation to second-line therapies after failure of methotrexate in patients with early rheumatoid arthritis does not reduce the risk of becoming difficult-to-treat.Arthritis research & therapy · 2024Article
- Characteristics of patients with difficult-to-treat rheumatoid arthritis: a descriptive retrospective cohort study.Advances in rheumatology (London, England) · 2024Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMost studies on difficult-to-treat rheumatoid arthritis (D2T RA) have focused on established RA. Here, we analyse whether disease activity in the early stages of RA could influence progression to a D2T RA under real-life conditions. Other clinical and treatment-related factors were also analysed.
methodsA longitudinal multicentre study of patients with RA was conducted from 2009 to 2018. Patients were followed up until January 2021. D2T RA was defined based on EULAR criteria (treatment failure, signs suggestive of currently active/progressive disease and management being perceived as problematic by the rheumatologist and/or patient). The main variable was disease activity in the early stages. The covariates were sociodemographic, clinical and treatment-related factors. We ran a multivariable logistic regression analysis to investigate risk factors associated with progression to D2T RA.
resultsThe study population comprised 631 patients and 35 (5.87%) developed D2T RA. At the time of diagnosis, the D2T RA group were younger, with a higher disability, 28-joint Disease Activity Score (DAS28) score, tender joint count and pain scores. In our final model, DAS28 was not statistically significantly associated with D2T RA. No differences were found between groups for therapy. Disability was independently associated with D2T RA (OR: 1.89; p=0.01).
conclusionsIn this cohort of patients newly diagnosed with RA, our results do not allow us to prove the influence of active disease according to DAS28. However, we did find that younger patients and those with elevated initial disability scores are more likely to develop D2T RA regardless of other factors.
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