More Noninflammatory Pain in Difficult to Treat RA Save
A Canadian cohort of difficult-to-treat rheumatoid arthritis (D2T RA) patients shows significantly more non-inflammatory pain in D2T RA compared to patients responding to b/tsDMARDs.
This study defined D2T RA patients according to the 2021 EULAR definition requiring patients to have failed ≥ 2 b/tsDMARDs (different mechanisms of action), and evidence of active disease (by SJC, TJC, ESR, CRP).
This retrospective single centre study identified adults RA patients as either D2TRA (based on EULAR definitions) or non-D2T RA (least response to one biologic or target synthetic DMARD (b/tsDMARD) for at least one year).
From a total of 417 RA patients, 101 (24%) were D2T RA and 316 (76%) were non-D2T RA.
D2T RA patients were slightly younger (63 versus 65 years, p = 0.045), had more non-inflammatory pain (28% versus 8%, p < 0.0001) and were more likey to be intolerant of at least one b/tsDMARD (39% versus 10%, p < 0.0001). Among D2T RA patients, JAK inhibitors were associated with longer drug continuation when used as the third b/tsDMARD.
Lastly, steroid-sparing strategies are possible even in D2T RA patients.
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Disclosures
The author has no conflicts of interest to disclose related to this subject
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