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. 2025 Sep 2;35(5):830-836.
doi: 10.1093/mr/roaf037.

Characterization of patients with rheumatoid arthritis not using biologic/targeted synthetic disease-modifying drugs despite insufficient disease control: Another difficult-to-treat RA

Hisakata Yamada  1 , Ryosuke Tsurui  2 , Masakazu Kondo  3 , Jun-Ichi Fukushi  4 , Koji Sakuraba  4 , Tomoya Miyamura  5 , Motoko Ishida  5 , Masataka Nakamura  5 , Yasushi Inoue  6 , Tomomi Tsuru  7 , Toshihide Shuto  8 , Seiji Yoshizawa  9 , Masanobu Ohishi  10 , Kenta Kamo  11 , Akihisa Haraguchi  11 , Akiza Maeyama  12 , Yojiro Arinobu  13 , Hiroki Mitoma  13 , Masahiro Ayano  13 , Nobuyuki Ono  13 , Yukio Akasaki  2 , Toshifumi Fujiwara  2 , Daisuke Hara  2 , Shinkichi Arisumi  2 , Keitaro Yasumoto  2 , Takahiro Natori  2 , Hiroaki Niiro  14 , Yasuharu Nakashima  2
Affiliations

Characterization of patients with rheumatoid arthritis not using biologic/targeted synthetic disease-modifying drugs despite insufficient disease control: Another difficult-to-treat RA

Hisakata Yamada et al. Mod Rheumatol. .

Abstract

Objectives: To understand the prevalence and characteristics of rheumatoid arthritis (RA) patients not using biologic/targeted synthetic disease-modifying drugs (b/tsDMARDs) despite insufficient disease control.

Methods: The data from 3172 RA patients in the FRANK (Fukuoka RA NetworK) registry, a Japanese registry of RA patients, were analysed. The patients were divided into groups based on the use of b/tsDMARDs and the reasons for not using them. Age, disease duration, drug use, activity of daily living (ADL) and quality of life (QOL) measures, the frequency of workers, and satisfaction with treatment were compared among the groups.

Results: About 10% of RA patients in the FRANK registry are non-users of b/tsDMARDs despite disease activity. The three major reasons for not using were the presence of comorbidity, economic reasons, and the patient's intent except for economic reasons. Patients with comorbidity and/or older age have low ADL/QOL but are mostly satisfied with the treatment. Intriguingly, patients not using b/tsDMARDs due to economic reasons are the youngest and have the highest proportion of workers.

Conclusions: We revealed the status of RA patients, non-users of b/tsDMARDs despite disease activity, who are not included in the European Alliance of Associations for Rheumatology (EULAR)-defined difficult-to-treat RA. About half of them might benefit from b/tsDMARD by patient education and socioeconomic support.

Keywords: Japanese; b/tsDMARD; epidemiology; registry; rheumatoid arthritis.

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