ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2488

Characteristics of Difficult-to-Treat Rheumatoid Arthritis: Results of an International Survey

Nadia MT Roodenrijs1, Maria JH de Hair1, Marlies C van der Goes1, Johannes W. G. Jacobs1, Paco MJ Welsing1, Désirée van der Heijde2, Daniel Aletaha3, Maxime Dougados4, Kimme L. Hyrich5, Iain B. McInnes6, Ulf Müller-Ladner7, Ladislav Šenolt8, Zoltan Szekanecz9, Jacob van Laar1 and Gyorgy Nagy10, 1Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands, Utrecht, Netherlands, 2Leiden University Medical Centre, Leiden, Netherlands, 3Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria, Vienna, Austria, 4Department of Rheumatology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris Descartes University, Paris, France, Paris, France, 5Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, United Kingdom, 6Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK, Glasgow, United Kingdom, 7Dept. of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus-Liebig-University Giessen, Germany, Bad Nauheim, Germany, 8First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic, 9Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, Debrecen, Hungary, 10Department of Genetics, Cell- and Immunobiology & Department of Rheumatology, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary, Budapest, Hungary

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Disease Activity, Rheumatoid arthritis (RA), treatment, treatment guidlelines and treatment options

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, October 23, 2018

Title: Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster III: Complications of Therapy, Outcomes, and Measures

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:
EULAR and ACR recommendations on the management of rheumatoid arthritis (RA) mainly focus on early RA and medication.1,2 Following these recommendations, several patients nevertheless remain symptomatic, which makes them difficult-to-treat.3 The estimated prevalence of difficult-to-treat RA ranges from 5 to 20%.4 A difficult-to-treat RA classification would enable making recommendations on its comprehensive management. We aimed to identify characteristics of difficult-to-treat RA and issues to be addressed in its comprehensive workup and management that are not covered by the current RA management recommendations.

Methods:
Among rheumatologists, an international survey was conducted. It included multiple-choice questions on disease characteristics of difficult-to-treat RA and open questions on additional items to be addressed and items missing in current management recommendations.

Results:
410 rheumatologists (a few of them in training) from 33 countries, mostly in Europe, completed the survey between July 2017 and March 2018 (Figure 1a). For disease characteristics of difficult-to-treat RA, 50% of respondents selected disease activity score assessing 28 joints (DAS28) >3.2 OR signs suggestive of active disease; 42% selected fatigue; 48% selected failure to ³2 conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) AND ³2 biological/targeted synthetic DMARDs; 89% selected inability to taper glucocorticoids below 5 or 10 mg prednisone equivalent daily (Figure 1b). Over 400 responses to the open questions were received (Figure 2). Comorbidities, extra-articular manifestations and polypharmacy were identified as important issues missing in current management recommendations.

Conclusion:
Concepts of difficult-to-treat RA vary considerably. Important issues regarding patients with difficult-to-treat RA, such as comorbidities, extra-articular manifestations and polypharmacy, are not addressed by current RA management recommendations.

References
1 Smolen JS, et al. Ann Rheum Dis 2017;76:960-77.
2 Singh JA, et al. Arthritis Rheum 2016;68:1-26.
3 de Hair MJH, et al. Rheumatology (Oxford) 2017.[Epub]
4 Kearsley-Fleet L, et al. Ann Rheum Dis 2017;76:960–77.

Description: O:\Reumatologie\Difficult to treat RA (Nadia)\4. Survey DtT RA\Abstract ACR\ACR abstract Figure 1.png

Description: O:\Reumatologie\Difficult to treat RA (Nadia)\4. Survey DtT RA\Abstract ACR\ACR abstract Figure 2.png


Disclosure: N. M. Roodenrijs, None; M. J. de Hair, None; M. C. van der Goes, None; J. W. G. Jacobs, None; P. M. Welsing, None; D. van der Heijde, Imaging Rheumatology BV, 3,AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Daiichi, Eli-Lilly, Galapagos, Gilead, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi and UCB Pharma, 5; D. Aletaha, None; M. Dougados, None; K. L. Hyrich, None; I. B. McInnes, None; U. Müller-Ladner, None; L. Šenolt, AbbVie, BMS, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Roche, Takeda, UCB, 5; Z. Szekanecz, None; J. van Laar, Arthrogen, MSD, Pfizer, Eli Lelly, BMS, Astra Zeneca, Roche-Genentech, 2, 5; G. Nagy, Amgen, AbbVie, BMS, KRKA, MSD, Pfizer, Roche, UCB, 2.

To cite this abstract in AMA style:

Roodenrijs NM, de Hair MJ, van der Goes MC, Jacobs JWG, Welsing PM, van der Heijde D, Aletaha D, Dougados M, Hyrich KL, McInnes IB, Müller-Ladner U, Šenolt L, Szekanecz Z, van Laar J, Nagy G. Characteristics of Difficult-to-Treat Rheumatoid Arthritis: Results of an International Survey [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/characteristics-of-difficult-to-treat-rheumatoid-arthritis-results-of-an-international-survey/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/characteristics-of-difficult-to-treat-rheumatoid-arthritis-results-of-an-international-survey/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology