title: Unresolved issues in identifying and overcoming inadequate response in rheumatoid arthritis: weighing the evidence.
abstract: Rheumatoid arthritis (RA) is a chronic, multisystem, inflammatory disorder of the joints that affects about 1% of the world population. The ultimate goals of therapy include remission of disease and prevention of joint damage. Reaching these goals has become a realistic outcome for an increasing number of patients as treatment options have expanded over the past 3 decades. In addition to older therapies, such as methotrexate (MTX), other disease modifying drugs (DMARD), and tumor necrosis factor (TNF) inhibitors, newer biologic treatments have become available. For the substantial number of patients who experience an inadequate response to standard medications, biologic response modifiers (BRM) provide an important therapeutic alternative. The availability of multiple treatment options in the absence of clear definitions or criteria for remission and inadequate response, however, makes clinical decisions about measuring outcomes, predicting response to treatment, and prescribing pharmacologic therapies challenging. In this program, distinguished rheumatologists weigh the evolving body of clinical evidence to draw sound conclusions and resolve key issues in managing inadequate response to treatment and in achieving optimal outcomes in RA.
authors.affiliation: The University of Texas Southwestern Medical Center, Office of Continuing Education, 5323 Harry Hines Blvd., Dallas, TX 75390-9059, USA.
authors.forename: Stanley B
authors.initials: SB
authors.lastname: Cohen
authors.forename: Marc D
authors.initials: MD
authors.lastname: Cohen
authors.forename: John J
authors.initials: JJ
authors.lastname: Cush
authors.forename: Roy M
authors.initials: RM
authors.lastname: Fleischmann
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.forename: Michael H
authors.initials: MH
authors.lastname: Schiff
authors.forename: Lee S
authors.initials: LS
authors.lastname: Simon
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Weaver
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D001688:Biological Products / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012074:Remission Induction; D018570:Risk Assessment; D012720:Severity of Illness Index; D017211:Treatment Failure
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D015415:Biomarkers