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

(Part 7)

Let’s continue with our discussion on the points to consider in the treatment of difficult to treat rheumatoid arthritis (D2T RA).

 It is said that the European Alliance of Associations for Rheumatology (EULAR) Task Force unanimously agreed with the PtC that composite indices and clinical evaluation should be interpreted with caution in the presence of comorbidities, in particular obesity and fibromyalgia§, as these may directly heighten inflammatory activity and could lead to an overestimated disease activity.

The Task Force was unanimous in its position that certain comorbidities might influence the assessment of inflammatory disease activity, and this may be noted for obesity and fibromyalgia.

These two conditions frequently coexist, further complicating the precise assessment of inflammatory disease activity in a patient.

Other comorbidities may lead to misclassification of inflammatory RA activity, although no substantial evidence was identified to support this concept.

It should be remembered that the identification of symptoms due to inflammation is generally more difficult in joints with damage.

The Task Force agreed that this PtC should refer to all potential comorbidities that may influence the evaluation of inflammatory disease activity.

Next week we will again discuss another PtC in order to provide relief to people with D2T RA.