Difficult-to-treat rheumatoid arthritis in real clinical practice. Preliminary results

• DOI: 10.26442/00403660.2022.05.201489
• Publication Date: 2022-06-17T16:33:23Z
• Authors: Elena A. Galushko; Andrey V. Gordeev; Elena V. Matyanova; Yury A. Olyunin; Evgeny L. Nasonov
• Keywords: Clinical Practice

Aim. To compare the features of course disease and therapy in rheumatoid arthritis (RA) patients who meet criteria difficult-to-treat RA (D2T). Materials methods. The study included 505 (ACR/EULAR 2010). Rheumatologist experts discussed all patients, since treatment ware perceived as problematic and/or insufficient. All had at least one following signs: activity is no lower than moderate; inability to reduce dose glucocorticoids low; rapid radiological progression; symptoms causing a decrease quality life. D2T group 35 with true inefficiency or intolerance two more bDMARDs/tsDMARDs different mechanism action. control (K) already experience taking class (n=291). Results. On average, every 15 (7%) met EULAR for D2T. median age was 45 years, which less K (Me 54 [43; 62] years; p=0.046). duration both groups comparable. severity articular destruction higher (stage IV 40% 23%, respectively). Positivity RF ACPA common (60% 85.9%; 60% 76.6%, presence systemic manifestations typical (28.6% 63%, p=0.0001). In number previously taken DMARDs (p=0.002). Methotrexate often prescribed first (in 62.9 65.7%, Initiation performed by TNF-a inhibitors (OR 2.8; p=0.003) co-stimulation blocker abatacept 4.6; p=0.004), B-cell inhibitor rituximab 6.9; p0.0001). Conclusion. results this suggest that Russia, well abroad, principle treat target has not yet become widespread, development adequate takes too much time.