Article
Rheumatology
Satoshi Takanashi, Yuko Kaneko, Tsutomu Takeuchi
Summary: This study investigated the clinical characteristics of patients with difficult-to-treat RA and the effectiveness of switching to drugs with different modes of action. The results showed that 10.1% of patients were still difficult to treat, and while changing drugs was useful, the proportion of patients achieving remission or low disease activity decreased with each switch.
Review
Rheumatology
Nadia M. T. Roodenrijs, Melinda Kedves, Attila Hamar, Gyorgy Nagy, Jacob M. van Laar, Desiree van der Heijde, Paco M. J. Welsing
Summary: This study summarized the evidence on diagnostic issues in difficult-to-treat rheumatoid arthritis (D2T RA) and found a scarcity of high-quality studies, no diagnostic tests with sufficient validity and accuracy identified, with ultrasonography (US) showing promise for assessing inflammatory activity.
Article
Chemistry, Physical
Jianhai Chen, Jianwei Tan, Jian Li, Wenxiang Cheng, Liqing Ke, Anqiao Wang, Qiqing Wang, Sien Lin, Gang Li, Benguo Wang, Jingqin Chen, Peng Zhang
Summary: This study presents a genetically engineered biomimetic membrane-coated mRNA (MR@P-mPTEN) carrier that effectively delivers mRNA-PTEN directly to the rheumatoid arthritis (RA) joint. The carrier is prepared by overexpressing tumor necrosis factor (TNF-α) receptors on macrophage biomimetic membranes, which serve as decoys to reduce inflammatory pathway activation. The results show that MR@P-mPTEN exhibits good stability, RA targeting, and competitive binding with TNF-α, activating the PTEN pathway to inhibit synovitis and joint damage.
Article
Rheumatology
Gyorgy Nagy, Nadia M. T. Roodenrijs, Paco M. J. Welsing, Melinda Kedves, Attila Hamar, Marlies C. van der Goes, Alison Kent, Margot Bakkers, Polina Pchelnikova, Etienne Blaas, Ladislav Senolt, Zoltan Szekanecz, Ernest H. Choy, Maxime Dougados, Johannes W. G. Jacobs, Rinie Geenen, Johannes W. J. Bijlsma, Angela Zink, Daniel Aletaha, Leonard Schoneveld, Piet van Riel, Sophie Dumas, Yeliz Prior, Elena Nikiphorou, Gianfranco Ferraccioli, Georg Schett, Kimme L. Hyrich, Ulf Mueller-Ladner, Maya H. Buch, Iain B. McInnes, Desiree van der Heijde, Jacob M. van Laar
Summary: The EULAR Task Force developed evidence-based points to consider for the management of difficult-to-treat rheumatoid arthritis, covering diagnostic confirmation, evaluation of inflammatory disease activity, pharmacological and non-pharmacological interventions, treatment adherence, functional disability, pain, fatigue, goal setting, self-efficacy, and impact of comorbidities. The strength of recommendations varied from level C to D, with a generally high level of agreement.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Review
Immunology
Ruo-Lan Li, Hu-Xinyue Duan, Qi Liang, Yong-Liang Huang, Ling-Yu Wang, Qing Zhang, Chun-Jie Wu, Shu-Qin Liu, Wei Peng
Summary: Matrix metalloproteinases (MMPs) play an important role in the development of rheumatoid arthritis (RA), and herbal medicines can inhibit the inflammatory process of RA by regulating MMPs and protecting joint structures.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Rheumatology
Yvonne Tan, Maya H. Buch
Summary: This review summarises the key concepts of difficult to treat rheumatoid arthritis (D2T-RA) defined by the European Alliance of Associations for Rheumatology. D2T-RA is primarily characterized by the failure of at least two different mechanism of action drugs with evidence of active/progressive disease. The review suggests additional considerations in the definition of D2T-RA and the potential value of identifying D2T traits and intervening before the development of D2T-RA state.
Article
Immunology
Hongtao Guo, Li Li, Bin Liu, Peipei Lu, Zhiwen Cao, Xinyu Ji, Guilin Ouyang, Zhixin Nie, Aiping Lyu, Cheng Lu
Summary: Difficult-to-treat rheumatoid arthritis (D2T RA) has become a major concern for rheumatologists due to its poor treatment response and persistent symptoms. The unclear causes and lack of data make it difficult to meet the therapeutic demands of D2T RA patients. This review discusses the challenges associated with disease-modifying antirheumatic drugs (DMARDs) and explores factors contributing to inappropriate response and immunological dysregulation in D2T RA.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2023)
Article
Engineering, Biomedical
Jia Tian, Tao Chen, Baoxuan Huang, Yang Liu, Chao Wang, Zepeng Cui, Hao Xu, Qiang Li, Weian Zhang, Qianqian Liang
Summary: In this study, a inflammation-specific environment activated methotrexate-encapsulated nanomedicine (MTX@NPs) was developed for the treatment of rheumatoid arthritis (RA). It effectively accumulated in inflamed joints and released methotrexate in the specific RA microenvironment. MTX@NPs demonstrated a high therapeutic efficacy for RA with minimal systemic toxicity by suppressing inflammation response and improving lymphatic functions.
ACTA BIOMATERIALIA
(2023)
Article
Rheumatology
Nadia M. T. Roodenrijs, Marlies C. van der Goes, Paco M. J. Welsing, Janneke Tekstra, Floris P. J. G. Lafeber, Johannes W. G. Jacobs, Jacob M. van Laar
Summary: The comprehensive study on D2T RA identified multiple contributing factors, a high burden of disease, and the heterogeneity of D2T RA subgroups. These findings suggest the importance of identifying these factors in daily practice to tailor therapeutic strategies to individual patients.
Article
Rheumatology
Doortje Krijbolder, Sarah J. H. Khidir, Annette H. M. van der Helm-van Mil
Summary: While awaiting therapies to prevent rheumatoid arthritis (RA) in individuals at-risk, a 1-year methotrexate treatment may lead to sustained reduction in disease burden and subclinical joint inflammation in patients with clinically suspect arthralgia (CSA). Both CSA patients and rheumatologists show a considerable willingness to start a 1-year treatment aimed at long-term improvement of symptoms and functioning, while not preventing RA.
Article
Engineering, Biomedical
Wenbo Geng, Xuezhe Liu, Bailong Tao, Ye He, Ke Li, Pengfei Gao, Qian Feng, Peng Zhao, Zhong Luo, Kaiyong Cai
Summary: This study reports a new block polymer that can scavenge NO and release H2S for the treatment of rheumatoid arthritis. In vitro and in vivo experiments demonstrate that the polymer can suppress reactive oxygen species and pro-inflammatory cytokines, regulate macrophage phenotype, and mitigate synovial inflammation. This work provides new insight into the synergistic treatment of rheumatoid arthritis and other endogenous gas-related diseases.
ADVANCED HEALTHCARE MATERIALS
(2023)
Article
Immunology
Jing-Wen Chen, Wen-Shuang Zhang, Chang-Song Lin, Qiang Xu
Summary: Rheumatoid arthritis (RA) is a complex chronic disease. Treatment options include disease modifying anti-rheumatic drugs (DMARDs) and biologic or targeted synthetic DMARDs. Dual therapy may be beneficial for difficult-to-treat RA patients.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Medicine, General & Internal
Judit Majnik, Noemi Csaszar-Nagy, Georgina Bocskei, Tamas Bender, Gyorgy Nagy
Summary: Although significant progress has been made in the pharmacological treatment of rheumatoid arthritis (RA), a considerable number of patients still do not achieve treatment goals. Non-pharmacological treatments (NPTs) play a crucial role, especially in difficult-to-treat RA (D2TRA), where pharmacological options are often limited. NPTs seem to have a complex, holistic effect that can complement targeted pharmacotherapies in the treatment of D2TRA.
FRONTIERS IN MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Xin-Yi Liu, Wen-Jun Pei, Ye-Zhen Wu, Fang-Li Ren, Si-Yu Yang, Xiu Wang
Summary: The study demonstrated that TPCX effectively enhances the water solubility of triptolide, improves transdermal permeability, and shows better therapeutic effects on rheumatoid arthritis (RA) rats.
Article
Rheumatology
Marta Novella-Navarro, Joseluis Cabrera-Alarcon, Natalia Lopez-Juanes, Alejandro Villalba, Elisa Fernandez Fernandez, Irene Monjo, Diana Peiteado, Laura Nuno, Chamaida Plasencia-Rodriguez, Alejandro Balsa
Summary: The study aims to analyze the trajectories of DAS28, PGA, and PhGA and assess their predictive capabilities for D2TRA classification.
