ReviewRheumatology (Oxford, England)2025
Difficult-to-treat rheumatoid arthritis: what have we learned and what do we still need to learn?
Review in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Therapeutic approaches for difficult-to-treat rheumatoid arthritis: a systematic literature review of current evidence.RMD open · 2026Pooled it
- CD19 CAR T cell therapy for treatment-refractory seropositive rheumatoid arthritis: a phase 1 trial.Nature medicine · 2026Trial
- Vagus nerve-mediated neuroimmune modulation for rheumatoid arthritis: a pivotal randomized controlled trial.Nature medicine · 2026Trial
- Trial
- Microemulsion-embedded hyaluronic acid microneedles improve local triptolide delivery and anti-arthritic efficacy in rheumatoid arthritis.International journal of pharmaceutics: X · 2026Article
- Clinical and healthcare burden of difficult-to-treat rheumatoid arthritis in Japan: a retrospective cohort study.BMJ open · 2026Observational
- Review
- Observational
- Emerging trends in the management of difficult-to-treat rheumatoid arthritis: targeted treatments and non-pharmacological interventions.Rheumatology (Oxford, England) · 2026Review
- Regenerative and Stem Cell-Based Therapies for Arthritis: Harnessing Mesenchymal Stem Cells, Exosomes, and Bioengineered Scaffolds for Functional Joint Repair.Stem cell reviews and reports · 2026Review
- [Clinical characteristics and outcomes of children with rheu-matoid factor-positive polyarticular juvenile idiopathic arthritis].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026Article
- Geroscience insights into difficult-to-treat rheumatoid arthritis: the role of unhealthy aging, comorbidity, and therapeutic complexity.GeroScience · 2026Review
- Psychosocial and behavioral correlates of persistent pain post disease-modifying treatment change in rheumatoid arthritis: a 12-month cohort study.Advances in rheumatology (London, England) · 2026Article
- Glucocorticoid sparing in rheumatoid arthritis patients treated with Janus kinase inhibitors: insights from the Japanese patient registry.Scientific reports · 2026Article
- Renal Vascular Involvement Assessed by Intrarenal Resistive Index in Patients with Rheumatoid Arthritis: Associations with Structural Joint Damage and Cardiovascular Risk.Journal of clinical medicine · 2026Article
- Spatial patterning of fibroblast TGFβ signaling underlies treatment resistance in rheumatoid arthritis.Nature immunology · 2026Article
- Selective use of musculoskeletal ultrasound in rheumatoid arthritis: from subclinical inflammation to clinical decision-making.Rheumatology international · 2026Review
- Pathogenic Drivers of Difficult-to-Treat Rheumatoid Arthritis: Synovium and Beyond.International journal of molecular sciences · 2026Review
- Fibroblast-like Synoviocytes as Key Regulators of Homeostasis and Inflammation in the Joint Microenvironment of Inflammatory Arthritis.Biomedicines · 2026Article
- Frontiers in Rheumatoid Arthritis: Emerging Research and Unmet Needs in Pharmacologic Management.Pharmaceuticals (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Difficult-to-treat RA (D2T RA) is an area of high unmet need. The prevalence reported in the first D2T RA cohort studies ranged from 5.5% to 27.5%. Key to the definition is a conviction by the patient and/or rheumatologist that disease management has become problematic and failure of at least two biological or targeted synthetic DMARDs. D2T RA is a multifactorial disease state which was reflected in data from D2T RA cohort studies: these pointed towards high prevalence of comorbidities and/or lower socioeconomic status in D2T RA subgroups, while others had persistent symptoms without these factors being present. A holistic approach is necessary to identify the root problems underlying D2T RA in individual patients. In this review, biological and non-biological drivers that should be considered to be optimized will be discussed in view of what we have learned from patient data emerging from the first D2T RA cohort studies.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.