1st refractory to DMARD can be bad omen. RA Study showed 41/402 (10%) were multi-DMARD refractory (MR) and 18% achieved remission/LDAS. DMARD MR predicted by erosions, younger age, high baseline DAS28, delta-DAS < 1.2 1st 6 mos (OR 11.12) https://t.co/KxdK97uuSI