General concepts of refractory and difficult-to-treat rheumatoid arthritis definitions
Abstract. Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic systemic inflammation and progressive joint destruction, extra-articular tissue and organ damage, progressive disability, risks of worsening comorbid conditions, deterioration in life quality, and premature mortality. Failure to achieve disease control or sustained remission with standard disease-modifying drugs necessitates modification of therapeutic regimens. Current review examines in details the criteria proposed by EULAR working group for identifying patients with difficult-to-treat RA (D2T-RA), and analyzes data from clinical observations, registries, and studies reflecting epidemiological data, possible predictors of development, and clinical subtypes of D2T-RA. The development of generally accepted criteria for identifying patients with refractory RA, new alternative therapeutic approaches, and their inclusion in national clinical guidelines are essential points for solving D2T-RA problem.Zagrebneva A.I., Simonova E.N., GavrikovA Yu.A., Dolgov V.V., Samigullina R.R., Mazurov V.I.
Keywords
rheumatoid arthritis
refractory rheumatoid arthritis
difficult-to-treat rheumatoid arthritis (D2T-RA)
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About the Authors
Alena I. Zagrebneva, MD, PhD (Medicine), chief external specialist – rheumatologist at the Department of Healthcare of Moscow; head of Moscow scientific and Practical Center For Immunobiological, Inflammatory, Rheumatic, and Autoimmune Inflammatory Diseases of Moscow Clinical Research Center, Hospital No. 52 the Department of Healthcare of Moscow; Highest Category Physician; associate professor of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 123182, Moscow, 3 Pekhotnaya St.E-mail: alrheumo@mail.ru
ORCID: https://orcid.org/0000-0002-3235-1425
Elena N. Simonova, MD, head of Consultative and Diagnostic Center No. 2, Moscow Clinical Research Center, Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya St.
E-mail: 4130524@mail.ru
ORCID: https://orcid.org/0000-0002-8372-6995
Yulia A. Gavrikova, MD, rheumatologist at Consultative and Diagnostic Center No. 2, Moscow Clinical Research Center, Hospital No. 52 of the Department of Healthcare of Moscow; specialist at Organizational and Methodological Department of Rheumatology, Research Institute for Healthcare Organization and Medical Management of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya St.
E-mail: jgavrikovagkb52@gmail.com
ORCID: https://orcid.org/0000-0001-8414-1545
Vladislav V. Dolgov, MD rheumatologist at Consultative and Diagnostic Center No. 2, Moscow Clinical Research Center, Hospital No. 52 of the Department of Healthcare of Moscow; specialist at Organizational and Methodological Department of Rheumatology, Research Institute for Healthcare Organization and Medical Management of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya St.
E-mail: drdolgovvv@gmail.com
ORCID: https://orcid.org/0000-0001-8007-5499
Ruzana R. Samigullina, MD, PhD (Medicine), assistant at the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; rheumatologist, head of the City Center for Therapy with Genetically Engineered Biological Drugs, V.A. Nasonova Clinical Rheumatological Hospital No. 25. Address: 191014, Saint Petersburg, 41 Kirochnaya St.
E-mail: dr.samigullina@yandex.ru
ORCID: https://orcid.org/0000-0002-6341-3334
Vadim I. Mazurov, MD, Dr. Sci. (Medicine), professor, academician of RAS, chief science advisor, director of the Research Institute of rheumatology, head of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; head of the Center of Autoimmune Diseases, V.A. Nasonova Clinical Rheumatological Hospital No. 25, Honored Scientist of the Russian Federation. Address: 191014, Saint Petersburg, 41 Kirochnaya St.
E-mail: maz.nwgmu@yandex.ru
ORCID: https://orcid.org/0000-0002-0797-2051
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