TY - JOUR
T1 - Inappropriate treatment response to DMARDs
T2 - A pathway to difficult-to-treat rheumatoid arthritis
AU - Guo, Hongtao
AU - Li, Li
AU - Liu, Bin
AU - Lu, Peipei
AU - Cao, Zhiwen
AU - Ji, Xinyu
AU - Li, Li
AU - Ouyang, Guilin
AU - Nie, Zhixin
AU - Lyu, Aiping
AU - Lu, Cheng
N1 - This work was supported by The National Natural Science Foundation of China (82074269), Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (ZYYCXTD-D-202005), Youth Qihuang Scholar of National Administration of Traditional Chinese Medicine (2020), Scientific and technological innovation project of China Academy of Chinese Medical Sciences (CI2021A01314), and the TCM Inheritance and innovation project of Henan province (CZ0237-13).
Publisher Copyright:
© 2023 The Authors.
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Contributing factors
KW - Difficult-to-treat
KW - DMARDs
KW - Inappropriate treatment response
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85167978606&partnerID=8YFLogxK
U2 - 10.1016/j.intimp.2023.110655
DO - 10.1016/j.intimp.2023.110655
M3 - Review article
C2 - 37481847
AN - SCOPUS:85167978606
SN - 1567-5769
VL - 122
JO - International Immunopharmacology
JF - International Immunopharmacology
M1 - 110655
ER -
