Patients with difficult-to-treat rheumatoid arthritis may represent biologically and clinically distinct groups depending on whether prior treatment “failure” reflects inadequate efficacy, intolerance, or a combination of both, according to a recent viewpoint. The researchers noted that the current European Alliance of Associations for Rheumatology definition provides a unifying framework for identifying these patients but lacks precision in real-world practice because it groups refractory disease with a wide range of complex clinical scenarios. They suggested clearer stratification of difficult-to-treat rheumatoid arthritis based on inadequate efficacy, toxicity, or mixed patterns, given that many patients cycle through numerous targeted therapies.

Source: RMD Open