Joint involvement patterns and patient-reported satisfaction in difficult-to-treat rheumatoid arthritis: results from...

Area of Science:

• Rheumatology
• Clinical Immunology
• Patient-Reported Outcomes

Background:

• Rheumatoid arthritis (RA) management aims for remission, but some patients develop difficult-to-treat RA (D2T RA).
• Characterizing D2T RA is essential for understanding its unique clinical profile and unmet needs.

Purpose of the Study:

• To define the specific patterns of joint involvement in D2T RA.
• To identify clinical features associated with D2T RA.
• To assess patient satisfaction in D2T RA compared to non-D2T RA.

Main Methods:

• Cross-sectional analysis of 3,770 patients from the FRANK Registry.
• D2T RA defined by 2021 EULAR criteria.
• Propensity score matching used to compare D2T RA with non-D2T RA patients.
• Joint involvement assessed via 28-joint counts and Paired Joint Pathology Scores (PJPS).
• Patient satisfaction evaluated across efficacy, cost, ADL, and global treatment domains.

Main Results:

• 2.9% of patients met D2T RA criteria (n=108).
• D2T RA patients showed higher ACPA titers, increased tsDMARD use, and higher rates of herpes zoster and MTX-LPD.
• Significant joint involvement observed in acromioclavicular, elbow, wrist, second PIP, and knee joints.
• D2T RA patients reported lower satisfaction, especially regarding treatment cost and daily functioning.

Conclusions:

• D2T RA presents with distinct joint involvement patterns and reduced patient satisfaction.
• A joint-focused, patient-centered management strategy is vital for improving outcomes in D2T RA.
• Further research into optimizing D2T RA treatment is warranted.