title: Management of refractory rheumatoid arthritis.
abstract: Based on the results of a MEDLINE search (1992-1997), the term 'refractory rheumatoid arthritis' (refractory RA) is ill-defined, in terms of both patient characterization and description of previous treatments. Current strategies of management of refractory RA include increasing disease-modifying anti-rheumatic drug dosage above standard dosage regimens, using combination therapy, and adding or increasing the dosage of corticosteroids. Options for further strategies include target-oriented biological agents (e.g. anti-tumour necrosis factor), gene therapy, stem-cell treatment and oral tolerance induction.
authors.affiliation: Department of Rheumatology, University Hospital Nijmegen St Radboud, The Netherlands.
authors.forename: L B
authors.initials: LB
authors.lastname: van de Putte
authors.forename: E J
authors.initials: EJ
authors.lastname: Kroot
authors.forename: P L
authors.initials: PL
authors.lastname: van Riel
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D005544:Forecasting; D006801:Humans; D017211:Treatment Failure