medwireNews: EULAR has issued evidence-based points to consider for the management of difficult-to-treat rheumatoid arthritis (RA).
This term “has recently been defined to characterise a heterogeneous group of patients with RA with persistent signs and symptoms,” explain György Nagy (Semmelweis University, Budapest, Hungary) and colleagues.
Based on systematic review and expert opinion, the team developed two overarching principles and 11 points to consider, which “promote individually tailored treatment interventions” through addressing specific aspects of DMARD selection and nonpharmacologic treatment strategies “to improve adherence, functional disability, pain, fatigue, goal setting and self-efficacy.”
The authors note in the Annals of the Rheumatic Diseases that “high-quality evidence was scarce,” and outlined a research agenda to guide future studies.
“Importantly, the heterogeneity of [difficult-to-treat] RA should be considered when conducting such studies, as not all management strategies will be helpful in all patients,” they emphasize.
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