ArticleOpen access rheumatology : research and reviews2026
Difficult-to-Treat Rheumatoid Arthritis in Saudi Arabia: Clinical Characteristics and Associated Factors in a Multicentre Study.
Article in Open access rheumatology : research and reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Difficult-to-treat rheumatoid arthritis (D2T RA) is a clinically challenging condition characterized by persistent disease activity despite appropriate disease-modifying antirheumatic drug (DMARD) therapy. Evidence regarding its frequency and contributing factors in Saudi Arabia remains limited. Objective: To determine the proportion of patients with D2T RA and identify the demographic, clinical, laboratory, and treatment-related factors associated with it in a multicentre Saudi cohort. Methods: This multicentre cross-sectional study used data from a registry of 928 patients with RA attending tertiary centres in Saudi Arabia. Patients were classified according to the EULAR definition as having D2T RA or controlled RA, defined as remission or low disease activity. Clinical, laboratory, and treatment-related characteristics were compared, and multivariable logistic regression identified factors independently associated with D2T RA. Results: Among 928 registry patients, 126 (13.6%) fulfilled the EULAR definition of D2T RA. For the comparative analysis, these patients were compared with 269 patients with controlled RA. D2T RA was associated with higher disease activity at the index visit, greater functional disability, elevated erythrocyte sedimentation rate, poorer patient global assessment, a longer interval between symptom onset and initial medical consultation, and lower treatment adherence. Joint deformities and swollen joint counts were more frequent, whereas C-reactive protein levels did not differ significantly. In multivariable analysis, age at diagnosis, longer disease duration, higher DAS28, greater Health Assessment Questionnaire disability, elevated erythrocyte sedimentation rate, poorer patient global assessment, treatment non-adherence, and methotrexate and glucocorticoid use were independently associated with D2T RA. Conclusion: Among patients with established RA and prolonged follow-up, 13.6% fulfilled the D2T RA criteria. D2T RA was associated with persistent inflammatory activity, accumulated disease burden, a longer interval before the first medical consultation, and potentially modifiable patient-related factors, particularly treatment adherence.
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.