医学
类风湿性关节炎
不利影响
重症监护医学
疾病
人口
抗风湿药物
抗风湿药
药品
内科学
物理疗法
药理学
环境卫生
作者
Hongtao Guo,Li Li,Bin Liu,Peipei Lu,Zhiwen Cao,Xinyu Ji,Li Li,Guilin Ouyang,Zhiqiang Nie,Aiping Lu,Cheng Lü
标识
DOI:10.1016/j.intimp.2023.110655
摘要
In recent years, difficult-to-treat rheumatoid arthritis (D2T RA) has attracted significant attention from rheumatologists due to its poor treatment response and the persistent symptoms or signs experienced by patients. The therapeutic demands of patients with D2T RA are not properly met due to unclear pathogenic causes and a lack of high-quality data for current treatment options, creating considerable management difficulties with this patient population. This review describes the clinical challenges associated with disease-modifying antirheumatic drugs (DMARDs) and explores contributing factors associated with inappropriate response to DMARDs that may lead to D2T RA and related immunological dysregulation. It is now understood that D2T RA is a highly heterogeneous pathological status that involves multiple factors. These factors include but are not limited to genetics, environment, immunogenicity, comorbidities, adverse drug reactions, inappropriate drug application, poor adherence, and socioeconomic status. Besides, these factors may manifest in the selection and utilization of specific DMARDs, either individually or in combination, thereby contributing to inadequate treatment response. Finding these variables may offer hints for enhancing DMARD therapy plans and bettering the condition of D2T RA patients.
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