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Review
. 2022 Aug 29:9:991677.
doi: 10.3389/fmed.2022.991677. eCollection 2022.

Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis

Judit Majnik  1   2 , Noémi Császár-Nagy  3 , Georgina Böcskei  2 , Tamás Bender  2 , György Nagy  1   4   5   6
Affiliations
Review

Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis

Judit Majnik et al. Front Med (Lausanne). .

Abstract

Although the management of rheumatoid arthritis (RA) has improved remarkably with new pharmacological therapies, there is still a significant part of patients not reaching treatment goals. Difficult-to-treat RA (D2TRA) is a complex entity involving several factors apart from persistent inflammation, thereafter requiring a holistic management approach. As pharmacological treatment options are often limited in D2TRA, the need for non-pharmacological treatments (NPT) is even more pronounced. The mechanism of action of non-pharmacological treatments is not well investigated, NPTs seem to have a complex, holistic effect including the immune, neural and endocrine system, which can have a significant additive benefit together with targeted pharmacotherapies in the treatment of D2TRA. In this review we summarize the current knowledge on different NPT in rheumatoid arthritis, and we propose a NPT plan to follow when managing D2TRA patients.

Keywords: difficult-to-treat; exercise; non-pharmacological; physiotherapy; psychotherapy; rheumatoid arthritis; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Different non-pharmacological treatment options in D2TRA.
FIGURE 2
FIGURE 2
Proposed structure of non-pharmacological treatment in D2TRA.
See this image and copyright information in PMC

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