Key points to consider for the management of difficult-to-treat rheumatoid arthritis (Part 2)

The treatment options for rheumatoid arthritis (RA) have been expanded following the availability of biological and targeted synthetic disease-modifying antirheumatic drugs (b/silent tsDMARDs).

Thus, the need for an updated European Alliance of Associations for Rheumatology (EULAR) recommendations for the management of 

RA focusing on drug therapy that are similar to what other international groups have done.

The recommendations and points to consider (PtCs) provide specific management support on cardiovascular disease (CVD) risk, comorbidities, imaging, pain  and patient education.

In the implementation of treat-to-target and tight control strategies, specifically in the early phase of the disease, these led to improved results for the majority of patients with RA.

Yet, some patients with RA do not achieve low disease activity or remission and may remain with symptoms despite the use of (b/silent tsDMARDs).

These patients may be referred to as having ‘difficult-to-treat (D2T)’ disease.

The management of these patients provides a significant challenge in clinical practice.

As such, there is no specific guideline that has been developed for the management of such condition.

As such, a task force has been formed to develop PtCs for the management of D2T RA.

Next week we will be discussing the methods used in coming up with PtC and guidelines for D2T RA.