Difficult-to-Treat Rheumatoid Arthritis Resolved in 45% Via Additional Treatment Changes

A June 8, 2024 study titled Five-year follow-up of patients with difficult-to-treat rheumatoid arthritis published in Rheumatology has fascinating results, and Remission Medical providers discussed it in depth in our Grand Rounds meeting last month.

Nearly half of patients with difficult-to-treat rheumatoid arthritis (D2T RA) no longer met the criteria for that status at the end of a five-year period, by reaching the status of disease remission or low disease activity with additional treatment modifications.

The retrospective study included 150 patients with D2T RA, and the Tokyo-based researchers followed patients until 2023, collecting data on demographics, treatment changes, disease activity, and outcomes.

The definition for D2T RA resolution was defined as “achieving remission or low disease activity for ≥ three (3) consecutive months.”

In total, 45% of patients achieved resolution of D2T RA at a mean duration of 24.1 months.  Treatment changes were more frequent in patients with resolved disease vs those with persistent D2T RA (83.6% vs 58.7%; P = .002).

And patients with resolved D2T RA were more frequently treated with interleukin-6 receptor inhibitors in 2023 vs 2018 (35.8% vs 20.0%, P = .04) and, by contrast, less often treated with prednisolone (14.9% vs 38.7%, P < .001).

Per the authors, “Although a treatment strategy for difficult-to-treat RA has not yet been established, our study suggests that the optimal treatment choice for patients with difficult-to-treat RA is distinct, based on the causes.”