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Difficult to treat rheumatoid arthritis in a comprehensive evaluation program: frequency according to different objective evaluations

  • Observational Research
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Abstract

Difficult-to-treat Rheumatoid Arthritis (RA-D2T) is a condition in which patients do not achieve the treatment target despite multiple advanced therapies, more others features. Aims: to estimate the frequency of RA-D2T in a cohort comprehensively evaluated (clinical, serology, imaging), and to analyze the associated characteristics. In a second part, the frequency of RA-D2T after 1 year of follow-up, analyzing the predictive variables at baseline and therapeutic behavior. Cross-sectional and prospective study, consecutive RA were included, then those who completed the one-year follow-up were evaluated. RA-D2T frequency was estimated (DAS28-CDAI-SDAI-Ultrasonography (US)-HAQ) at baseline and 1 year. The variables associated and those baseline predictive characteristics of D2T at 1 year, and their independent association by logistic regression were analyzed. The treatment approach was described. Two hundred seventy-six patients completed the evaluation, frequency of RA-D2T (all scores): 27.5%. Anemia, RF high titers and higher HAQ score were independent associated. At year, 125 competed follow-up. RA-D2T (all scores): 33%, D2T-US and D2T-HAQ were 14 and 18.4% (p 0.001). Predictive baseline characteristics D2T (all score): ACPA + (OR: 13.7) and X-ray erosion (OR: 2.9). D2T-US: X-ray erosion (OR: 19.7). Conventional DMARDs, corticosteroids and TNF-blockers were the drugs most used by D2T patients, Jaki were the most used in the switch. We showed different frequencies of RA-D2T according to different objective parameters (scores, images) and their association with patient characteristics. In turn, predictive variables (erosions—ACPA) for RA-D2T at 1 year were analyzed. It was shown that the Jaki were the most used drug in these patients.

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The data is openly available on request.

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Funding

The present study has no funding to declare.

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Authors and Affiliations

  1. Rheumatology Unit, Hospital Italiano de La Plata, 51 Street, 1725, 1900, La Plata, Buenos Aires Province, Argentina

    Rodrigo Garcia-Salinas, Einer Sanchez-Prado, Jonatan Mareco, Perez Ronald, Santiago Ruta & Sebastian Magri

  2. Rheumatolgy Unit, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina

    Jonatan Mareco & Ramiro Gomez

Authors
  1. Rodrigo Garcia-Salinas
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  2. Einer Sanchez-Prado
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  3. Jonatan Mareco
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  4. Perez Ronald
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  5. Santiago Ruta
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  6. Ramiro Gomez
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  7. Sebastian Magri
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Contributions

All authors contributed substantially to the conception and design of the work and the acquisition and interpretation of the data according to ICMJE. RGS, SR, and RG additionally analyzed the data and drafted the initial version of the manuscript. The final manuscript has been revised critically and approved by all the authors, who are fully responsible for the integrity and accuracy of all aspects of the work.

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Correspondence to Rodrigo Garcia-Salinas.

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Garcia-Salinas, R., Sanchez-Prado, E., Mareco, J. et al. Difficult to treat rheumatoid arthritis in a comprehensive evaluation program: frequency according to different objective evaluations. Rheumatol Int 43, 1821–1828 (2023). https://doi.org/10.1007/s00296-023-05349-8

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  • DOI: https://doi.org/10.1007/s00296-023-05349-8

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