Bohol Tribune
Opinion

Medical Insider – Dr. Cora E. Lim

EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis

(Part 5)

Allow me to start the discussion on the results of the formulation of the points to consider (PtC) for the management of difficult to treat rheumatoid arthritis (D2T RA).

The PtCs complement the current European Alliance of Associations for Rheumatology (EULAR) recommendations that also address elements of management of D2T RA.2

The systematic literature review (SLRs) and the formulation of the PtCs predominantly focused on topics not addressed previously and refer to several published and ongoing EULAR projects.

The discussion of the Task Force resulted in 2 overarching principles and 11 PtCs.

The Task Force formulated the following overarching principles which are:

a.) The PtCs pertain to patients who fulfil the definition of D2T RA and are underpinned by the EULAR recommendations for the management of RA.

b.) The presence or absence of inflammation should be established to guide pharmacological and non-pharmacological methods.

The EULAR Task Force emphasized the presence of inflammatory RA disease activity is needed and should be done prior to adjustment of disease modifying anti-rheumatism drugs (DMARD) therapy.

Moreover, when there is inflammation these should be considered. It was agreed that in the absence of inflammation, DMARD therapy should not be given further.

This overarching principle was accepted in the second round of the voting process.

Next week we will be dealing with further discussions on the points to consider.

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