Difficult to treat rheumatoid arthritis: a review and relevance to Africa

Abstract

Background: Rheumatologists are sometimes confronted with rheumatoid arthritis patients, who despite adequate management are unable to achieve a remission or low disease activity; of recent, the terminology ‘Difficult-to-Treat Rheumatoid Arthritis’ has been adopted.
Objective: To identify the definition, causes, and management of these patients. The peculiar factors causing ‘Difficultto-Treat RA’ in African patients are also identified.
Data source: These were obtained from literature search on this subject as stated in the references and on Pubmed search
Conclusions: Difficult-to-Treat RA constitutes a large group of patients in rheumatology practice. The causes are multifactorial. It is important to identify the factors responsible in the patients and institute appropriate measures. Since the definition factors the use of Biologics or JAK inhibitors, rheumatologists in Africa need to do further research on this subject while also providing the definition and management of this condition.