ArticleRheumatology (Oxford, England)2025
Prevalence and characteristics of adults with difficult-to-treat rheumatoid arthritis in a large patient registry.
Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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
13 citing papers in PubMed.
- Securidaca inappendiculata Extract Mitigates Joint Damage in Collagen-Induced Arthritis Rats Through Modulation of the SIRT1/HIF-1α/Glycolysis Pathway.Pharmacology research & perspectives · 2026Article
- Clinical and healthcare burden of difficult-to-treat rheumatoid arthritis in Japan: a retrospective cohort study.BMJ open · 2026Observational
- Emerging trends in the management of difficult-to-treat rheumatoid arthritis: targeted treatments and non-pharmacological interventions.Rheumatology (Oxford, England) · 2026Review
- Pathogenic Drivers of Difficult-to-Treat Rheumatoid Arthritis: Synovium and Beyond.International journal of molecular sciences · 2026Review
- Observational
- Plant-derived extracellular vesicles as emerging biotherapeutic agents and delivery vehicles for rheumatoid arthritis: evidence from preclinical models.Frontiers in immunology · 2026Review
- Difficult-to-Treat Rheumatoid Arthritis in Saudi Arabia: Clinical Characteristics and Associated Factors in a Multicentre Study.Open access rheumatology : research and reviews · 2026Article
- Gut dysbiosis in difficult-to-treat rheumatoid arthritis: hypothesized microbial endotypes, persistent inflammation, and pharmacological treatment resistance.Frontiers in pharmacology · 2026Review
- Development and External Validation of a Multivariable Predictive Model for Progression to Difficult-to-Treat Rheumatoid Arthritis in Biologic-Experienced Patients.Arthritis care & research · 2026Article
- Beyond Inflammation: Why Understanding the Brain Matters in Inflammatory Arthritis.Arthritis care & research · 2026Review
- Single-Center Cross-Sectional Analysis of Patients with RA, SpA, and PsA: Data from the Prescription Database.Journal of personalized medicine · 2025Article
- 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
- The potential role of fatigue in difficult-to-treat rheumatoid arthritis.BMC rheumatology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesAn estimated 5-20% of patients with rheumatoid arthritis (RA) fail multiple treatments and are considered 'difficult-to-treat' (D2T), posing a substantial clinical challenge for rheumatologists. A European League Against Rheumatism (EULAR) task force proposed a definition of D2T-RA in 2021. We applied EULAR's D2T definition in a cohort of patients with established RA to assess prevalence, and we compared clinical characteristics of participants with D2T-RA with matched comparisons.
methodsData from the longitudinal Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) registry were used. Participants were classified as D2T if they met EULAR's definition. A comparison group of non-D2T-RA patients were matched 2:1 to every D2T patient, and differences in characteristics were evaluated in descriptive analyses. Prevalence rates of D2T were estimated using Poisson regression.
resultsWe estimated the prevalence of D2T-RA to be 14.4 (95% CI: 12.8, 16.3) per 100 persons among 1581 participants with RA, and 22.3 (95% CI: 19.9, 25.0) per 100 persons among 1021 who were biologic/targeted synthetic DMARD experienced. We observed several differences in demographics, comorbidities and RA disease activity between D2T-RA and non-D2T-RA comparisons. Varying EULAR sub-criteria among all participants in BRASS resulted in a range of D2T-RA prevalence rates, from 0.6 to 17.5 per 100 persons.
conclusionEULAR's proposed definition of D2T-RA identifies patients with RA who have not achieved treatment targets. Future research should explore heterogeneity in these patients and evaluate outcomes to inform the design of future studies aimed at developing more effective RA management protocols.
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.