OBJECTIVE: To develop evidence-based European Alliance of Associations for Rheumatology (EULAR) points to consider (PtCs) for the management of difficult-to-treat rheumatoid arthritis (D2T RA). METHODS: An EULAR Task Force was established comprising 34 individuals: 26 rheumatologists, patient partners and rheumatology experienced health professionals. Two systematic literature reviews addressed clinical questions around diagnostic challenges, and pharmacological and non-pharmacological therapeutic strategies in D2T RA. PtCs were formulated based on the identified evidence and expert opinion. Strength of recommendations (SoR, scale A-D: A typically consistent level 1 studies and D level 5 evidence or inconsistent studies) and level of agreement (LoA, scale 0-10: 0 completely disagree and 10 completely agree) of the PtCs were determined by the Task Force members. RESULTS: Two overarching principles and 11 PtCs were defined concerning diagnostic confirmation of RA, evaluation of inflammatory disease activity, pharmacological and non-pharmacological interventions, treatment adherence, functional disability, pain, fatigue, goal setting and self-efficacy and the impact of comorbidities. The SoR varied from level C to level D. The mean LoA with the overarching principles and PtCs was generally high (8.4-9.6). CONCLUSIONS: These PtCs for D2T RA can serve as a clinical roadmap to support healthcare professionals and patients to deliver holistic management and more personalised pharmacological and non-pharmacological therapeutic strategies. High-quality evidence was scarce. A research agenda was created to guide future research.

Bács Kiskun County Hospital Rheumatology Department Kecskemét Hungary

Centre for Musculoskeletal Research School of Biological Sciences Faculty of Biology Medicine and Health University of Manchester Manchester UK

Centre for Rheumatic Diseases King's College London London UK

CREATE Centre Section of Rheumatology School of Medicine Division of Infection and Immunity Cardiff University Cardiff UK

Department of Genetics Cell and Immunobiology Semmelweis University Budapest Hungary

Department of Internal Medicine 3 Division of Rheumatology Medical University of Vienna Vienna Austria

Department of Internal Medicine 3 Rheumatology and Immunology Friedrich Alexander University of Erlangen Nuremberg and Universitatsklinikum Erlangen Erlangen Germany

Department of Pharmacy Marin Hospital Asisstance Publique Hopitaux de Paris Hendaye France

Department of Psychology Utrecht University Utrecht The Netherlands

Department of Rheumatic Diseases Radboud University Nijmegen Medical Centre Nijmegen The Netherlands

Department of Rheumatology 1st Faculty of Medicine Charles University and Institute of Rheumatology Prague Czech Republic

Department of Rheumatology and Clinical Immunology Justus Liebig University Giessen Campus Kerckhoff Bad Nauheim Germany

Department of Rheumatology and Clinical Immunology Semmelweis University Budapest Hungary

Department of Rheumatology and Clinical Immunology University Medical Center Utrecht Utrecht University Utrecht The Netherlands

Department of Rheumatology Bravis Hospital Roosendaal The Netherlands

Department of Rheumatology Faculty of Medicine University of Debrecen Debrecen Hungary

Department of Rheumatology Leiden University Medical Center Leiden The Netherlands

Department of Rheumatology Meander Medical Center Amersfoort The Netherlands

Epidemiology Unit German Rheumatism Research Centre Berlin Germany

EULAR Standing Committee of People with Arthritis Rheumatism in Europe Zurich Switzerland

Institute of Infection Immunity and Inflammation University of Glasgow Glasgow UK

Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK

NIHR Manchester Biomedical Research Centre Manchester University NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK

Rheumatology Department King's College Hospital London UK

Salisbury Foundation Trust NHS Hospital Wiltshire UK

School of Health and Society Centre for Health Sciences Research University of Salford Salford UK

School of Medicine Catholic University of the Sacred Heart Rome Italy

Université de Paris Department of Rheumatology Hôpital Cochin Assistance Publique Hôpitaux de Paris INSERM Clinical epidemiology and biostatistics PRES Sorbonne Paris Cité Paris France

Zobrazit více v PubMed

Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet 2016;388:2023–38. 10.1016/S0140-6736(16)30173-8 PubMed DOI

Smolen JS, Landewé RBM, Bijlsma JWJ, et al. . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020;79:685–99. 10.1136/annrheumdis-2019-216655 PubMed DOI

Singh JA, Saag KG, Bridges SL. American College of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2015;2016:1–26. PubMed

Brenol CV, Nava JIG, Soriano ER. Proper management of rheumatoid arthritis in Latin America. what the guidelines say? Clin Rheumatol 2015;34:51–5. 10.1007/s10067-015-3016-9 PubMed DOI PMC

Lau CS, Chia F, Dans L, et al. . 2018 update of the APLAR recommendations for treatment of rheumatoid arthritis. Int J Rheum Dis 2019;22:357–75. 10.1111/1756-185X.13513 PubMed DOI

Agca R, Heslinga SC, Rollefstad S, et al. . EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 2017;76:17–28. 10.1136/annrheumdis-2016-209775 PubMed DOI

Baillet A, Gossec L, Carmona L, et al. . Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Ann Rheum Dis 2016;75:965–73. 10.1136/annrheumdis-2016-209233 PubMed DOI

Colebatch AN, Edwards CJ, Østergaard M, et al. . EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013;72:804–14. 10.1136/annrheumdis-2012-203158 PubMed DOI

Geenen R, Overman CL, Christensen R, et al. . EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018;77:797–807. 10.1136/annrheumdis-2017-212662 PubMed DOI

Zangi HA, Ndosi M, Adams J, et al. . EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis 2015;74:954–62. 10.1136/annrheumdis-2014-206807 PubMed DOI

Smolen JS, Breedveld FC, Burmester GR, et al. . Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international Task force. Ann Rheum Dis 2016;75:3–15. 10.1136/annrheumdis-2015-207524 PubMed DOI PMC

Buch MH. Defining refractory rheumatoid arthritis. Ann Rheum Dis 2018;77:966–9. 10.1136/annrheumdis-2017-212862 PubMed DOI

de Hair MJH, Jacobs JWG, Schoneveld JLM. Difficult-To-Treat rheumatoid arthritis: an area of unmet clinical need. Rheumatology 2017;57:1135–44. PubMed

Buch MH, Eyre S, McGonagle D. Persistent inflammatory and non-inflammatory mechanisms in refractory rheumatoid arthritis. Nat Rev Rheumatol 2021;17:17–33. 10.1038/s41584-020-00541-7 PubMed DOI

Roodenrijs NMT, de Hair MJH, van der Goes MC, et al. . Characteristics of difficult-to-treat rheumatoid arthritis: results of an international survey. Ann Rheum Dis 2018;77:1705–9. 10.1136/annrheumdis-2018-213687 PubMed DOI

van der Heijde D, Aletaha D, Carmona L, et al. . 2014 update of the EULAR standardised operating procedures for EULAR-endorsed recommendations. Ann Rheum Dis 2015;74:8–13. 10.1136/annrheumdis-2014-206350 PubMed DOI PMC

Nagy G, Roodenrijs NM, Welsing PM, et al. . EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis 2021;80:31–5. 10.1136/annrheumdis-2020-217344 PubMed DOI PMC

Ritschl V, Stamm TA, Aletaha D, et al. . Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews Informing the 2020 EULAR points to consider. RMD Open 2020;6:e001432. 10.1136/rmdopen-2020-001432 PubMed DOI PMC

Ritschl V, Stamm TA, Aletaha D, et al. . 2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice. Ann Rheum Dis 2021;80:707–13. 10.1136/annrheumdis-2020-218986 PubMed DOI

Roodenrijs NMT, Kedves M, Hamar A, et al. . Diagnostic issues in difficult-to-treat rheumatoid arthritis: a systematic literature review Informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis. RMD Open 2021;7:e001511. 10.1136/rmdopen-2020-001511 PubMed DOI PMC

Roodenrijs NMT, Hamar A, Kedves M, et al. . Pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis: a systematic literature review Informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis. RMD Open 2021;7:e001512. 10.1136/rmdopen-2020-001512 PubMed DOI PMC

OCEBM Levels of Evidence Working Group, Oxford Centre for Evidence-Based Medicine . The Oxford 2011 levels of evidence, 2011. Available: https://www.cebm.net/2016/05/ocebm-levels-of-evidence/

Macfarlane GJ, Kronisch C, Dean LE, et al. . EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017;76:318–28. 10.1136/annrheumdis-2016-209724 PubMed DOI

Kloppenburg M, Kroon FPB, Blanco FJ. Update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 2018;2019:16–24. PubMed

Fernandes L, Hagen KB, Bijlsma JWJ, et al. . EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 2013;72:1125–35. 10.1136/annrheumdis-2012-202745 PubMed DOI

Roodenrijs NMT, van der Goes MC, Welsing PMJ, et al. . Difficult-To-Treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology 2020:keaa860. 10.1093/rheumatology/keaa860 PubMed DOI

Pedersen JK, Lorenzen T, Ejbjerg B, et al. . Low-Field magnetic resonance imaging or combined ultrasonography and anti-cyclic citrullinated peptide antibody improve correct classification of individuals as established rheumatoid arthritis: results of a population-based, cross-sectional study. BMC Musculoskelet Disord 2014;15:268. 10.1186/1471-2474-15-268 PubMed DOI PMC

Fan A, Tournadre A, Pereira B, et al. . Performance of fibromyalgia rapid screening tool (first) to detect fibromyalgia syndrome in rheumatic diseases. Rheumatology 2016;55:1746–50. 10.1093/rheumatology/kew244 PubMed DOI

Ghib LJ, Cojocneanu-Petric R, Budisan L. THU0518 the diagnostic value of selected microRNAs in patients with fibromyalgia associated with rheumatoid arthritis: a pilot study. Ann Rheum Dis 2018;77:463.3–4.

Salaffi F, Di Carlo M, Carotti M, et al. . The subjective components of the disease activity score 28-joints (DAS28) in rheumatoid arthritis patients and coexisting fibromyalgia. Rheumatol Int 2018;38:1911–8. 10.1007/s00296-018-4096-z PubMed DOI

Sato H, Tanabe N, Murasawa A, et al. . Procalcitonin is a specific marker for detecting bacterial infection in patients with rheumatoid arthritis. J Rheumatol 2012;39:1517–23. 10.3899/jrheum.111601 PubMed DOI

Paalanen K, Puolakka K, Nikiphorou E. Is seronegative rheumatoid arthritis true rheumatoid arthritis? A nationwide cohort study. Rheumatology 2021;60:keaa623–2395. 10.1093/rheumatology/keaa623 PubMed DOI PMC

Nikiphorou E, Sjöwall C, Hannonen P, et al. . Long-term outcomes of destructive seronegative (rheumatoid) arthritis - description of four clinical cases. BMC Musculoskelet Disord 2016;17:246. 10.1186/s12891-016-1067-y PubMed DOI PMC

Aletaha D, Neogi T, Silman AJ. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis 2010;2010:1580–8. PubMed

Burgers LE, Raza K, van der Helm-van Mil AH. Window of opportunity in rheumatoid arthritis - definitions and supporting evidence: from old to new perspectives. RMD Open 2019;5:V. 10.1136/rmdopen-2018-000870 PubMed DOI PMC

Landewé RBM. Overdiagnosis and overtreatment in rheumatology: a little caution is in order. Ann Rheum Dis 2018;77:1394–6. 10.1136/annrheumdis-2018-213700 PubMed DOI

Jacobs JWG, van Rijthoven AWAM. [Diagnostic image (290). A woman with painful finger joints and swelling]. Ned Tijdschr Geneeskd 2006;150:1982. PubMed

Ceponis A, Onishi M, Bluestein HG, et al. . Utility of the ultrasound examination of the hand and wrist joints in the management of established rheumatoid arthritis. Arthritis Care Res 2014;66:236–44. 10.1002/acr.22119 PubMed DOI

Filer A, Mandelin AI, DiCarlo E. Histological and Clinical Correlates of Ultrasound Measures of Joint Inflammation: Analysis of RA Tissue Obtained By Ultrasound Guided Biopsy in Phase 1 of the Accelerating Medicines Partnership RA Network [abstract]. Arthritis Rheumatol 2017;69 https://acrabstracts.org/abstract/histological-and-clinical-correlates-ofultrasound-measures-of-joint-inflammation-analysis-of-ra-tissue-obtained-by-ultrasoundguided-biopsy-in-phase-1-of-the-accelerating-medicines-partnership-ra-ne/

Kawashiri S-ya, Kawakami A, Iwamoto N, et al. . The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis. Rheumatology 2011;50:962–5. 10.1093/rheumatology/keq415 PubMed DOI

Mandl P, Naredo E, Wakefield RJ, et al. . A systematic literature review analysis of ultrasound joint count and scoring systems to assess synovitis in rheumatoid arthritis according to the OMERACT filter. J Rheumatol 2011;38:2055–62. 10.3899/jrheum.110424 PubMed DOI

Yokota K, Tsuzuki Wada T, Akiyama Y, et al. . Detection of synovial inflammation in rheumatic diseases using superb microvascular imaging: comparison with conventional power Doppler imaging. Mod Rheumatol 2018;28:327–33. 10.1080/14397595.2017.1337288 PubMed DOI

Vlad V, Berghea F, Libianu S, et al. . Ultrasound in rheumatoid arthritis: volar versus dorsal synovitis evaluation and scoring. BMC Musculoskelet Disord 2011;12:124. 10.1186/1471-2474-12-124 PubMed DOI PMC

Ngai Ng S, Bjørndal Axelsen M, Ostergaard M. OP0135 how well does whole body magnetic resonance imaging agree with whole body ultrasound in the assessment of joint inflammation in rheumatoid arthritis patients. Ann Rheum Dis 2019;78:143.

Takase-Minegishi K, Horita N, Kobayashi K, et al. . Diagnostic test accuracy of ultrasound for synovitis in rheumatoid arthritis: systematic review and meta-analysis. Rheumatology 2018;57:49–58. 10.1093/rheumatology/kex036 PubMed DOI

Ciurtin C, Brown G, Cotton A. THU0138 Das 28 correlated poorly with the objective evidence of inflammation as detected by ultrasound (US) examination of hands and feet in patients with established rheumatoid arthritis (rA). Ann Rheum Dis 2017;76:253.1–253.

Senolt L, Housa D, Vernerová Z, et al. . Resistin in rheumatoid arthritis synovial tissue, synovial fluid and serum. Ann Rheum Dis 2007;66:458–63. 10.1136/ard.2006.054734 PubMed DOI PMC

Skacelova M, Hermanova Z, Horak P, et al. . Higher levels of matrix metalloproteinase-3 in patients with RA reflect disease activity and structural damage. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017;161:296–302. 10.5507/bp.2017.015 PubMed DOI

Tuncer T, Kaya A, Gulkesen A, et al. . Matrix metalloproteinase-3 levels in relation to disease activity and radiological progression in rheumatoid arthritis. Adv Clin Exp Med 2019;28:665–70. 10.17219/acem/94065 PubMed DOI

Yildirim K, Karatay S, Melikoglu MA. Associations between acute phase reactant levels and disease activity score (DAS28) in patients with rheumatoid arthritis. Ann Clin Lab Sci 2004;34:423–6. PubMed

van Onna M, Ten Cate DF, Tsoi KL, et al. . Assessment of disease activity in patients with rheumatoid arthritis using optical spectral transmission measurements, a non-invasive imaging technique. Ann Rheum Dis 2016;75:511–8. 10.1136/annrheumdis-2015-207315 PubMed DOI PMC

Meier AJL, Rensen WHJ, de Bokx PK, et al. . Potential of optical spectral transmission measurements for joint inflammation measurements in rheumatoid arthritis patients. J Biomed Opt 2012;17:081420. 10.1117/1.JBO.17.8.081420 PubMed DOI

Besselink NJ, van der Meijde P, Rensen WHJ, et al. . Optical spectral transmission to assess inflammation in hand and wrist joints of rheumatoid arthritis patients. Rheumatology 2018;57:865–72. 10.1093/rheumatology/kex531 PubMed DOI

Bae S-C, Lee YH. Mir-146A levels in rheumatoid arthritis and their correlation with disease activity: a meta-analysis. Int J Rheum Dis 2018;21:1335–42. 10.1111/1756-185X.13338 PubMed DOI

Bustos Rivera-Bahena C, Xibillé-Friedmann D-X, González-Christen J, et al. . Peripheral blood leptin and resistin levels as clinical activity biomarkers in Mexican rheumatoid arthritis patients. Reumatol Clin 2016;12:323–6. 10.1016/j.reuma.2015.11.011 PubMed DOI

do Prado AD, Bisi MC, Piovesan DM, et al. . Ultrasound power Doppler synovitis is associated with plasma IL-6 in established rheumatoid arthritis. Cytokine 2016;83:27–32. 10.1016/j.cyto.2016.03.014 PubMed DOI

Johnson TM, Register KA, Schmidt CM, et al. . Correlation of the Multi‐Biomarker disease activity score with rheumatoid arthritis disease activity measures: a systematic review and Meta‐Analysis. Arthritis Care Res 2019;71:1459–72. 10.1002/acr.23785 PubMed DOI PMC

Milman N, Karsh J, Booth RA. Correlation of a multi-cytokine panel with clinical disease activity in patients with rheumatoid arthritis. Clin Biochem 2010;43:1309–14. 10.1016/j.clinbiochem.2010.07.012 PubMed DOI

Nordal HH, Brokstad KA, Solheim M, et al. . Calprotectin (S100A8/A9) has the strongest association with ultrasound-detected synovitis and predicts response to biologic treatment: results from a longitudinal study of patients with established rheumatoid arthritis. Arthritis Res Ther 2017;19:3. 10.1186/s13075-016-1201-0 PubMed DOI PMC

Roodenrijs NMT, de Hair MJH, Wheater G, et al. . The multi-biomarker disease activity score tracks response to rituximab treatment in rheumatoid arthritis patients: a post hoc analysis of three cohort studies. Arthritis Res Ther 2018;20:256. 10.1186/s13075-018-1750-5 PubMed DOI PMC

Rooney T, Scherzer R, Shigenaga JK, et al. . Levels of plasma fibrinogen are elevated in well-controlled rheumatoid arthritis. Rheumatology 2011;50:1458–65. 10.1093/rheumatology/ker011 PubMed DOI

Bauer EM, Ben-Artzi A, Duffy EL, et al. . Joint-specific assessment of swelling and power Doppler in obese rheumatoid arthritis patients. BMC Musculoskelet Disord 2017;18:99. 10.1186/s12891-017-1406-7 PubMed DOI PMC

Sosa J, Karina Perez S, Julia Santa Cruz M. M-DAS28, M-SDAI and M-CDAI Performance in a Cohort of RA Patients with and without Concomitant Fibromyalgia [abstract]. Arthritis Rheumatol 2017;69 https://acrabstracts.org/abstract/m-das28-m-sdai-andm-cdai-performance-in-a-cohort-of-ra-patients-with-and-without-concomitant-fibromyalgia

Ranganath VK, Duffy EL, Garg VK, et al. . Obesity impacts swelling of ankle and foot joints in early rheumatoid arthritis patients. J Clin Rheumatol 2019;25:e8–11. 10.1097/RHU.0000000000000799 PubMed DOI PMC

Goossens J, Coustet B, Palazzo E. Overweight and obesity affect clinical assessment of synovitis in rheumatoid arthritis: comparison of ultrasonography and clinical exam. Clin Exp Rheumatol 2019;37:49–54. PubMed

van den Bemt BJF, Zwikker HE, van den Ende CHM. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert Rev Clin Immunol 2012;8:337–51. 10.1586/eci.12.23 PubMed DOI

Murage MJ, Tongbram V, Feldman SR, et al. . Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence 2018;12:1483–503. 10.2147/PPA.S167508 PubMed DOI PMC

López-Medina C, Moltó A, Gérald F, et al. . Assessment of the adherence to disease-modifying drugs in patients with chronic inflammatory rheumatic diseases: results of a survey of 1594 patients. Joint Bone Spine 2019;86:610–4. 10.1016/j.jbspin.2019.01.023 PubMed DOI

Contreras-Yáñez I, Ponce De León S, Cabiedes J, et al. . Inadequate therapy behavior is associated to disease flares in patients with rheumatoid arthritis who have achieved remission with disease-modifying antirheumatic drugs. Am J Med Sci 2010;340:282–90. 10.1097/MAJ.0b013e3181e8bcb0 PubMed DOI

De Vera MA, Mailman J, Gao JS. Economics of non-adherence to biologic therapies in rheumatoid arthritis topical collection on health economics and quality of life. Curr Rheumatol Rep 2014;16:460. PubMed

Salaffi F, Carotti M, Di Carlo M, et al. . Adherence to anti-tumor necrosis factor therapy administered subcutaneously and associated factors in patients with rheumatoid arthritis. J Clin Rheumatol 2015;21:419–25. 10.1097/RHU.0000000000000320 PubMed DOI

Pasma A, Schenk CV, Timman R, et al. . Non-adherence to disease-modifying antirheumatic drugs is associated with higher disease activity in early arthritis patients in the first year of the disease. Arthritis Res Ther 2015;17:281. 10.1186/s13075-015-0801-4 PubMed DOI PMC

Pasma A, Schenk C, Timman R, et al. . Does non-adherence to DMARDs influence hospital-related healthcare costs for early arthritis in the first year of treatment? PLoS One 2017;12:e0171070. 10.1371/journal.pone.0171070 PubMed DOI PMC

Sabaté E. WHO | adherence to long-term therapies: evidence for action. Geneva: World Health Organization, 2015. PubMed

Lam WY, Fresco P. Medication adherence measures: an overview. Biomed Res Int 2015;2015:1–12. 10.1155/2015/217047 PubMed DOI PMC

Gossec L, Molto A, Romand X, et al. . Recommendations for the assessment and optimization of adherence to disease-modifying drugs in chronic inflammatory rheumatic diseases: a process based on literature reviews and expert consensus. Joint Bone Spine 2019;86:13–19. 10.1016/j.jbspin.2018.08.006 PubMed DOI

Joplin S, van der Zwan R, Joshua F, et al. . Medication adherence in patients with rheumatoid arthritis: the effect of patient education, health literacy, and musculoskeletal ultrasound. Biomed Res Int 2015;2015:150658. 10.1155/2015/150658 PubMed DOI PMC

Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns 2006;60:301–12. 10.1016/j.pec.2005.06.010 PubMed DOI

Dy SM, Purnell TS. Key concepts relevant to quality of complex and shared decision-making in health care: a literature review. Soc Sci Med 2012;74:582–7. 10.1016/j.socscimed.2011.11.015 PubMed DOI PMC

Kerschbaumer A, Sepriano A, Smolen JS, et al. . Efficacy of pharmacological treatment in rheumatoid arthritis: a systematic literature research Informing the 2019 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis 2020;79:744–59. 10.1136/annrheumdis-2019-216656 PubMed DOI PMC

Kearsley-Fleet L, Davies R, De Cock D, et al. . Biologic refractory disease in rheumatoid arthritis: results from the British Society for rheumatology biologics register for rheumatoid arthritis. Ann Rheum Dis 2018;77:1405–12. 10.1136/annrheumdis-2018-213378 PubMed DOI PMC

Emery P, Keystone E, Tony HP, et al. . Il-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-week multicentre randomised placebo-controlled trial. Ann Rheum Dis 2008;67:1516–23. 10.1136/ard.2008.092932 PubMed DOI PMC

Burmester GR, Blanco R, Charles-Schoeman C, et al. . Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet 2013;381:451–60. 10.1016/S0140-6736(12)61424-X PubMed DOI

Genovese MC, Fleischmann RM, Greenwald M, et al. . Tabalumab, an anti-BAFF monoclonal antibody, in patients with active rheumatoid arthritis with an inadequate response to TNF inhibitors. Ann Rheum Dis 2013;72:1461–8. 10.1136/annrheumdis-2012-202775 PubMed DOI

Genovese MC, Kalunian K, Gottenberg J-E, et al. . Effect of Filgotinib vs placebo on clinical response in patients with moderate to severe rheumatoid arthritis refractory to disease-modifying antirheumatic drug therapy: the finch 2 randomized clinical trial. JAMA 2019;322:315–25. 10.1001/jama.2019.9055 PubMed DOI PMC

Kremer JM, Emery P, Camp HS, et al. . A phase IIb study of ABT-494, a selective JAK-1 inhibitor, in patients with rheumatoid arthritis and an inadequate response to anti-tumor necrosis factor therapy. Arthritis Rheumatol 2016;68:2867–77. 10.1002/art.39801 PubMed DOI PMC

Weinblatt M, Thomson G, Chen K. FRI0171 clinical responses in patients with inadequate response to bdmards upon treatment with upadacitinib. Ann Rheum Dis 2019;78:759.

Alivernini S, Laria A, Gremese E, et al. . ACR70-disease activity score remission achievement from switches between all the available biological agents in rheumatoid arthritis: a systematic review of the literature. Arthritis Res Ther 2009;11:R163. 10.1186/ar2848 PubMed DOI PMC

Kim H-L, Lee M-Y, Park S-Y, et al. . Comparative effectiveness of cycling of tumor necrosis factor-α (TNF-α) inhibitors versus switching to non-TNF biologics in rheumatoid arthritis patients with inadequate response to TNF-α inhibitor using a Bayesian approach. Arch Pharm Res 2014;37:662–70. 10.1007/s12272-014-0337-1 PubMed DOI

Lee YH, Bae S-C. Comparative efficacy and safety of tocilizumab, rituximab, abatacept and tofacitinib in patients with active rheumatoid arthritis that inadequately responds to tumor necrosis factor inhibitors: a Bayesian network meta-analysis of randomized controlled trials. Int J Rheum Dis 2016;19:1103–11. 10.1111/1756-185X.12822 PubMed DOI

Malottki K, Barton P, Tsourapas A, et al. . Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation. Health Technol Assess 2011;15:1–300. 10.3310/hta15140 PubMed DOI PMC

Singh JA, Hossain A, Tanjong Ghogomu E, et al. . Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2017;2017. 10.1002/14651858.CD012591 PubMed DOI PMC

Smolen JS, Kay J, Matteson EL, et al. . Insights into the efficacy of golimumab plus methotrexate in patients with active rheumatoid arthritis who discontinued prior anti-tumour necrosis factor therapy: post-hoc analyses from the GO-AFTER study. Ann Rheum Dis 2014;73:1811–8. 10.1136/annrheumdis-2013-203435 PubMed DOI PMC

Schiff M, Pritchard C, Huffstutter JE, et al. . The 6-month safety and efficacy of abatacept in patients with rheumatoid arthritis who underwent a washout after anti-tumour necrosis factor therapy or were directly switched to abatacept: the ARRIVE trial. Ann Rheum Dis 2009;68:1708–14. 10.1136/ard.2008.099218 PubMed DOI PMC

Harrold LR, Reed GW, Magner R, et al. . Comparative effectiveness and safety of rituximab versus subsequent anti-tumor necrosis factor therapy in patients with rheumatoid arthritis with prior exposure to anti-tumor necrosis factor therapies in the United States Corrona registry. Arthritis Res Ther 2015;17:256. 10.1186/s13075-015-0776-1 PubMed DOI PMC

Charles-Schoeman C, Kremer J, Krishnaswami S. THU0185 comparison of tofacitinib safety and efficacy in rheumatoid arthritis patients with inadequate response to conventional synthetic dmards, or to one or more biological dmards. Ann Rheum Dis 2017;76:271.3–2.

Genovese MC, Kremer JM, Kartman CE, et al. . Response to baricitinib based on prior biologic use in patients with refractory rheumatoid arthritis. Rheumatology 2018;57:900–8. 10.1093/rheumatology/kex489 PubMed DOI PMC

Chatzidionysiou K, van Vollenhoven RF. Rituximab versus anti-TNF in patients who previously failed one TNF inhibitor in an observational cohort. Scand J Rheumatol 2013;42:190–5. 10.3109/03009742.2012.729607 PubMed DOI

Emery P, Gottenberg JE, Rubbert-Roth A, et al. . Rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis who failed to respond to a single previous TNF inhibitor: SWITCH-RA, a global, observational, comparative effectiveness study. Ann Rheum Dis 2015;74:979–84. 10.1136/annrheumdis-2013-203993 PubMed DOI PMC

Gomez-Reino JJ, Maneiro JR, Ruiz J, et al. . Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR study. Ann Rheum Dis 2012;71:1861–4. 10.1136/annrheumdis-2012-201324 PubMed DOI

Kekow J, Mueller-Ladner U, Schulze-Koops H. Rituximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNFα blocker failure. Biol Targets Ther 2012;6:191–9. PubMed PMC

Soliman MM, Hyrich KL, Lunt M, et al. . Rituximab or a second anti–tumor necrosis factor therapy for rheumatoid arthritis patients who have failed their first anti–tumor necrosis factor therapy? comparative analysis from the British Society for rheumatology biologics register. Arthritis Care Res 2012;64:1108–15. 10.1002/acr.21663 PubMed DOI PMC

Torrente-Segarra V, Acosta Pereira A, Morla R. VARIAR study: assessment of short-term efficacy and safety of rituximab compared to an tumor necrosis factor alpha antagonists as second-line drug therapy in patients with rheumatoid arthritis refractory to a first tumor necrosis factor alpha antagonist. Reumatol Clínica 2016;12:319–22. PubMed

Harrold LR, Reed GW, Best J, et al. . Real-World comparative effectiveness of tocilizumab monotherapy vs. tumor necrosis factor inhibitors with methotrexate in patients with rheumatoid arthritis. Rheumatol Ther 2018;5:507–23. 10.1007/s40744-018-0127-1 PubMed DOI PMC

Hirabara S, Takahashi N, Fukaya N, et al. . Clinical efficacy of abatacept, tocilizumab, and etanercept in Japanese rheumatoid arthritis patients with inadequate response to anti-TNF monoclonal antibodies. Clin Rheumatol 2014;33:1247–54. 10.1007/s10067-014-2711-2 PubMed DOI PMC

Lauper K, Nordström DC, Pavelka K, et al. . Comparative effectiveness of tocilizumab versus TNF inhibitors as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis after the use of at least one biologic disease-modifying antirheumatic drug: analyses from the pan-European TOCERRA register collaboration. Ann Rheum Dis 2018;77:1276–82. 10.1136/annrheumdis-2017-212845 PubMed DOI

Vial G, De PA, Scouppe L. FRI0234 choice of biologic therapy following rituximab: influencing factors in a French multicenter cohort of rheumatoid arthritis. Ann Rheum Dis 2017;76:573.2–4.

Walker UA, Jaeger VK, Chatzidionysiou K, et al. . Rituximab done: what's next in rheumatoid arthritis? a European observational longitudinal study assessing the effectiveness of biologics after rituximab treatment in rheumatoid arthritis. Rheumatology 2016;55:230–6. 10.1093/rheumatology/kev297 PubMed DOI

Gottenberg J-E, Brocq O, Perdriger A, et al. . Non–TNF-Targeted biologic vs a second anti-TNF drug to treat rheumatoid arthritis in patients with insufficient response to a first anti-TNF drug. JAMA 2016;316:1172–80. 10.1001/jama.2016.13512 PubMed DOI

Wei W, Knapp K, Wang L, et al. . Treatment persistence and clinical outcomes of tumor necrosis factor inhibitor cycling or switching to a new mechanism of action therapy: real-world observational study of rheumatoid arthritis patients in the United States with prior tumor necrosis factor inhibitor therapy. Adv Ther 2017;34:1936–52. 10.1007/s12325-017-0578-8 PubMed DOI PMC

González-Vacarezza N, Alemán A, González G, et al. . Rituximab and tocilizumab for the treatment of rheumatoid arthritis. Int J Technol Assess Health Care 2014;30:282–8. 10.1017/S0266462314000221 PubMed DOI

Nam JL, Takase-Minegishi K, Ramiro S, et al. . Efficacy of biological disease-modifying antirheumatic drugs: a systematic literature review Informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2017;76:1108–13. 10.1136/annrheumdis-2016-210713 PubMed DOI

Akiyama M, Kaneko Y, Kondo H, et al. . Comparison of the clinical effectiveness of tumour necrosis factor inhibitors and abatacept after insufficient response to tocilizumab in patients with rheumatoid arthritis. Clin Rheumatol 2016;35:2829–34. 10.1007/s10067-016-3227-8 PubMed DOI

Harrold LR, Reed GW, Kremer JM, et al. . The comparative effectiveness of abatacept versus anti-tumour necrosis factor switching for rheumatoid arthritis patients previously treated with an anti-tumour necrosis factor. Ann Rheum Dis 2015;74:430–6. 10.1136/annrheumdis-2013-203936 PubMed DOI PMC

Brown S, Everett CC, Naraghi K, et al. . Alternative tumour necrosis factor inhibitors (TNFi) or abatacept or rituximab following failure of initial TNFi in rheumatoid arthritis: the switch RCT. Health Technol Assess 2018;22:1–280. 10.3310/hta22340 PubMed DOI PMC

Taylor PC, Atzeni F, Balsa A, et al. . The key comorbidities in patients with rheumatoid arthritis: a narrative review. J Clin Med 2021;10:509. 10.3390/jcm10030509 PubMed DOI PMC

Sepriano A, Kerschbaumer A, Smolen JS, et al. . Safety of synthetic and biological DMARDs: a systematic literature review Informing the 2019 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2020;79:760–70. 10.1136/annrheumdis-2019-216653 PubMed DOI

Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. . The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 2016;75:795–810. 10.1136/annrheumdis-2015-208840 PubMed DOI

Sammaritano LR, Bermas BL, Chakravarty EE, et al. . 2020 American College of rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol 2020;72:529-556. 10.1002/art.41191 PubMed DOI

Clowse MEB, Feldman SR, Isaacs JD, et al. . Pregnancy outcomes in the tofacitinib safety databases for rheumatoid arthritis and psoriasis. Drug Saf 2016;39:755–62. 10.1007/s40264-016-0431-z PubMed DOI PMC

Hoeltzenbein M, Beck E, Rajwanshi R, et al. . Tocilizumab use in pregnancy: analysis of a global safety database including data from clinical trials and post-marketing data. Semin Arthritis Rheum 2016;46:238–45. 10.1016/j.semarthrit.2016.05.004 PubMed DOI

Mouyis M, Flint JD, Giles IP. Safety of anti-rheumatic drugs in men trying to conceive: a systematic review and analysis of published evidence. Semin Arthritis Rheum 2019;48:911–20. 10.1016/j.semarthrit.2018.07.011 PubMed DOI

Nikiphorou E, Norton S, Young A, et al. . The association of obesity with disease activity, functional ability and quality of life in early rheumatoid arthritis: data from the early rheumatoid arthritis Study/Early rheumatoid arthritis network UK prospective cohorts. Rheumatology 2018;57:1194–202. 10.1093/rheumatology/key066 PubMed DOI

Gremese E, Carletto A, Padovan M, et al. . Obesity and reduction of the response rate to anti-tumor necrosis factor α in rheumatoid arthritis: an approach to a personalized medicine. Arthritis Care Res 2013;65:94–100. 10.1002/acr.21768 PubMed DOI

Klaasen R, Wijbrandts CA, Gerlag DM, et al. . Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum 2011;63:359–64. 10.1002/art.30136 PubMed DOI

Cantini F, Boccia S, Goletti D, et al. . Hbv reactivation in patients treated with antitumor necrosis factor-alpha (TNF-α) agents for rheumatic and dermatologic conditions: a systematic review and meta-analysis. Int J Rheumatol 2014;2014:926836. 10.1155/2014/926836 PubMed DOI PMC

Padovan M, Filippini M, Tincani A, et al. . Safety of abatacept in rheumatoid arthritis with serologic evidence of past or present hepatitis B virus infection. Arthritis Care Res 2016;68:738–43. 10.1002/acr.22786 PubMed DOI

Chen L-F, Mo Y-Q, Jing J, et al. . Short-Course tocilizumab increases risk of hepatitis B virus reactivation in patients with rheumatoid arthritis: a prospective clinical observation. Int J Rheum Dis 2017;20:859–69. 10.1111/1756-185X.13010 PubMed DOI

Lin K-M, Cheng T-T, Lin J-C, et al. . Tumor necrosis factor-α antagonist therapy for concomitant rheumatoid arthritis and hepatitis C virus infection: a case series study. Clin Rheumatol 2015;34:1039–46. 10.1007/s10067-015-2962-6 PubMed DOI

Brunasso AMG, Puntoni M, Gulia A, et al. . Safety of anti-tumour necrosis factor agents in patients with chronic hepatitis C infection: a systematic review. Rheumatology 2011;50:1700–11. 10.1093/rheumatology/ker190 PubMed DOI

Rausch Osthoff A-K, Niedermann K, Braun J. EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018;2018:1251–60. PubMed

Eversden L, Maggs F, Nightingale P, et al. . A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC Musculoskelet Disord 2007;8:23. 10.1186/1471-2474-8-23 PubMed DOI PMC

Figen A, Geçene M, Gündüz R. Long-Term effects of comprehensive inpatient rehabilitation on function and disease activity in patients with chronic rheumatoid arthritis and ankylosing spondylitis. Turkish J Rheumatol 2011;26:135–44.

Williams MA, Srikesavan C, Heine PJ, et al. . Exercise for rheumatoid arthritis of the hand. Cochrane Database Syst Rev 2018;7:CD003832. 10.1002/14651858.CD003832.pub3 PubMed DOI PMC

Lau YN, Ng J, Lee SY, et al. . A brief report on the clinical trial on neural mobilization exercise for joint pain in patients with rheumatoid arthritis. Z Rheumatol 2019;78:474–8. 10.1007/s00393-018-0521-7 PubMed DOI

Feldthusen C, Dean E, Forsblad-d'Elia H, et al. . Effects of Person-Centered physical therapy on Fatigue-Related variables in persons with rheumatoid arthritis: a randomized controlled trial. Arch Phys Med Rehabil 2016;97:26–36. 10.1016/j.apmr.2015.09.022 PubMed DOI

Macedo AM, Oakley SP, Panayi GS, et al. . Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy. Arthritis Rheum 2009;61:1522–30. 10.1002/art.24563 PubMed DOI

Siqueira US, Orsini Valente LG, de Mello MT, et al. . Effectiveness of aquatic exercises in women with rheumatoid arthritis: a randomized, controlled, 16-Week Intervention-The Hydra trial. Am J Phys Med Rehabil 2017;96:167–75. 10.1097/PHM.0000000000000564 PubMed DOI

Christie A, Jamtvedt G, Dahm KT, et al. . Effectiveness of nonpharmacological and nonsurgical interventions for patients with rheumatoid arthritis: an overview of systematic reviews. Phys Ther 2007;87:1697–715. 10.2522/ptj.20070039 PubMed DOI

Hurkmans E, van der Giesen FJ, Vliet Vlieland TP. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database Syst Rev 2009;2009:CD006853. 10.1002/14651858.CD006853.pub2 PubMed DOI PMC

Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology 2007;46:1648–51. 10.1093/rheumatology/kem151 PubMed DOI

Santos EJF, Duarte C, Marques A, et al. . Effectiveness of non-pharmacological and non-surgical interventions for rheumatoid arthritis: an umbrella review. JBI Database System Rev Implement Rep 2019;17:1494–531. 10.11124/JBISRIR-D-18-00020 PubMed DOI

Manning VL, Hurley MV, Scott DL, et al. . Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res 2014;66:217–27. 10.1002/acr.22102 PubMed DOI

Macfarlane GJ, Paudyal P, Doherty M, et al. . A systematic review of evidence for the effectiveness of practitioner-based complementary and alternative therapies in the management of rheumatic diseases: rheumatoid arthritis. Rheumatology 2012;51:1707–13. 10.1093/rheumatology/kes133 PubMed DOI

Hewlett S, Almeida C, Ambler N, et al. . Group cognitive-behavioural programme to reduce the impact of rheumatoid arthritis fatigue: the raft RCT with economic and qualitative evaluations. Health Technol Assess 2019;23:1–130. 10.3310/hta23570 PubMed DOI PMC

Ferwerda M, van Beugen S, van Middendorp H, et al. . A tailored-guided Internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumatological care: results of a randomized controlled trial. Pain 2017;158:868–78. 10.1097/j.pain.0000000000000845 PubMed DOI

Dixon KE, Keefe FJ, Scipio CD, et al. . Psychological interventions for arthritis pain management in adults: a meta-analysis. Health Psychol 2007;26:241–50. 10.1037/0278-6133.26.3.241 PubMed DOI

Prothero L, Barley E, Galloway J, et al. . The evidence base for psychological interventions for rheumatoid arthritis: a systematic review of reviews. Int J Nurs Stud 2018;82:20–9. 10.1016/j.ijnurstu.2018.03.008 PubMed DOI

Dissanayake RK, Bertouch JV. Psychosocial interventions as adjunct therapy for patients with rheumatoid arthritis: a systematic review. Int J Rheum Dis 2010;13:324–34. 10.1111/j.1756-185X.2010.01563.x PubMed DOI

Baxter SV, Hale LA, Stebbings S, et al. . Walking is a feasible physical activity for people with rheumatoid arthritis: a feasibility randomized controlled trial. Musculoskeletal Care 2016;14:47–56. 10.1002/msc.1112 PubMed DOI

DiRenzo D, Crespo-Bosque M, Gould N, et al. . Systematic review and meta-analysis: mindfulness-based interventions for rheumatoid arthritis. Curr Rheumatol Rep 2018;20:75. 10.1007/s11926-018-0787-4 PubMed DOI PMC

Hammond A, Young A, Kidao R. A randomised controlled trial of occupational therapy for people with early rheumatoid arthritis. Ann Rheum Dis 2004;63:23–30. 10.1136/ard.2002.001511 PubMed DOI PMC

Knittle K, De Gucht V, Hurkmans E, et al. . Targeting motivation and self-regulation to increase physical activity among patients with rheumatoid arthritis: a randomised controlled trial. Clin Rheumatol 2015;34:231–8. 10.1007/s10067-013-2425-x PubMed DOI

Mollard E, Michaud K. A mobile APP with optical imaging for the self-management of hand rheumatoid arthritis: pilot study. JMIR Mhealth Uhealth 2018;6:e12221. 10.2196/12221 PubMed DOI PMC

Albano MG, Giraudet-Le Quintrec J-S, Crozet C, et al. . Characteristics and development of therapeutic patient education in rheumatoid arthritis: analysis of the 2003-2008 literature. Joint Bone Spine 2010;77:405–10. 10.1016/j.jbspin.2010.01.010 PubMed DOI

Iversen MD, Hammond A, Betteridge N. Self-Management of rheumatic diseases: state of the art and future perspectives. Ann Rheum Dis 2010;69:955–63. 10.1136/ard.2010.129270 PubMed DOI

Srikesavan C, Bryer C, Ali U, et al. . Web-Based rehabilitation interventions for people with rheumatoid arthritis: a systematic review. J Telemed Telecare 2019;25:263–75. 10.1177/1357633X18768400 PubMed DOI

Anvar N, Matlabi H, Safaiyan A, et al. . Effectiveness of self-management program on arthritis symptoms among older women: a randomized controlled trial study. Health Care Women Int 2018;39:1326–39. 10.1080/07399332.2018.1438438 PubMed DOI

El Miedany Y, El Gaafary M, El Arousy N, et al. . Arthritis education: the integration of patient-reported outcome measures and patient self-management. Clin Exp Rheumatol 2012;30:899–904. PubMed

Fraenkel L, Peters E, Charpentier P, et al. . Decision tool to improve the quality of care in rheumatoid arthritis. Arthritis Care Res 2012;64:977–85. 10.1002/acr.21657 PubMed DOI PMC

Fraenkel L, Matzko CK, Webb DE, et al. . Use of decision support for improved knowledge, values clarification, and informed choice in patients with rheumatoid arthritis. Arthritis Care Res 2015;67:1496–502. 10.1002/acr.22659 PubMed DOI PMC

Li LC, Adam PM, Backman CL, et al. . Proof-Of-Concept study of a web-based methotrexate decision aid for patients with rheumatoid arthritis. Arthritis Care Res 2014;66:1472–81. 10.1002/acr.22319 PubMed DOI

Li LC, Shaw CD, Lacaille D, et al. . Effects of a web-based patient decision aid on biologic and small-molecule agents for rheumatoid arthritis: results from a proof-of-concept study. Arthritis Care Res 2018;70:343–52. 10.1002/acr.23287 PubMed DOI

Taal E, Rasker JJ, Wiegman O. Patient education and self-management in the rheumatic diseases: a self-efficacy approach. Arthritis Care Res 1996;9:229–38. 10.1002/1529-0131(199606)9:3<229::aid-anr1790090312>3.0.co;2-u PubMed DOI

Barlow JH, Cullen LA, Rowe IF. Educational preferences, psychological well-being and self-efficacy among people with rheumatoid arthritis. Patient Educ Couns 2002;46:11–19. 10.1016/s0738-3991(01)00146-x PubMed DOI

Bandura A. Self-efficacy. In: the corsini encyclopedia of psychology. Hoboken, NJ, USA: John Wiley & Sons, Inc, 2010: 1–3.

Lorig K, Chastain RL, Ung E, et al. . Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 1989;32:37–44. 10.1002/anr.1780320107 PubMed DOI

Garratt AM, Løchting I, Smedslund G, et al. . Measurement properties of instruments assessing self-efficacy in patients with rheumatic diseases. Rheumatology 2014;53:1161–71. 10.1093/rheumatology/ket374 PubMed DOI

Gibofsky A, Galloway J, Kekow J, et al. . Comparison of patient and physician perspectives in the management of rheumatoid arthritis: results from global physician- and patient-based surveys. Health Qual Life Outcomes 2018;16:211. 10.1186/s12955-018-1035-3 PubMed DOI PMC

Silvers IJ, Hovell MF, Weisman MH, et al. . Assessing physician/patient perceptions in rheumatoid arthritis. A vital component in patient education. Arthritis Rheum 1985;28:300–7. 10.1002/art.1780280310 PubMed DOI

Barlow JH, Wright CC. Knowledge in patients with rheumatoid arthritis: a longer term follow-up of a randomized controlled study of patient education leaflets. Br J Rheumatol 1998;37:373–6. 10.1093/rheumatology/37.4.373 PubMed DOI

Hosseini Moghadam M, Jahanbin I, Nazarinia MA. The effect of educational program on self-efficacy of women with rheumatoid arthritis: a randomized controlled clinical trial. Int J Community Based Nurs Midwifery 2018;6:12–20. PubMed PMC

Niedermann K, de Bie RA, Kubli R, et al. . Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial. Patient Educ Couns 2011;82:42–8. 10.1016/j.pec.2010.02.014 PubMed DOI

Niedermann K, Buchi S, Ciurea A, et al. . Six and 12 months' effects of individual joint protection education in people with rheumatoid arthritis: a randomized controlled trial. Scand J Occup Ther 2012;19:360–9. 10.3109/11038128.2011.611820 PubMed DOI

Riemsma RP, Taal E, Brus HL, et al. . Coordinated individual education with an arthritis passport for patients with rheumatoid arthritis. Arthritis Care Res 1997;10:238–49. 10.1002/art.1790100405 PubMed DOI

Hewlett S, Ambler N, Almeida C, et al. . Self-Management of fatigue in rheumatoid arthritis: a randomised controlled trial of group cognitive-behavioural therapy. Ann Rheum Dis 2011;70:1060–7. 10.1136/ard.2010.144691 PubMed DOI PMC

Lineker SC, Bell MJ, Wilkins AL. Improvements following short term home based physical therapy are maintained at one year in people with moderate to severe rheumatoid arthritis. J Rheumatol 2001;28:165–8. PubMed

Breedland I, van Scheppingen C, Leijsma M, et al. . Effects of a group-based exercise and educational program on physical performance and disease self-management in rheumatoid arthritis: a randomized controlled study. Phys Ther 2011;91:879–93. 10.2522/ptj.20090010 PubMed DOI

Lorig KR, Ritter PL, Laurent DD, et al. . The Internet-based arthritis self-management program: a one-year randomized trial for patients with arthritis or fibromyalgia. Arthritis Rheum 2008;59:1009–17. 10.1002/art.23817 PubMed DOI

Siu AMH, Chui DYY. Evaluation of a community rehabilitation service for people with rheumatoid arthritis. Patient Educ Couns 2004;55:62–9. 10.1016/j.pec.2003.08.001 PubMed DOI

Bell MJ, Lineker SC, Wilkins AL, et al. . A randomized controlled trial to evaluate the efficacy of community based physical therapy in the treatment of people with rheumatoid arthritis. J Rheumatol 1998;25:231–7. PubMed

Najm A, Nikiphorou E, Kostine M, et al. . EULAR points to consider for the development, evaluation and implementation of mobile health applications Aiding self-management in people living with rheumatic and musculoskeletal diseases. RMD Open 2019;5:e001014. 10.1136/rmdopen-2019-001014 PubMed DOI PMC

Lahiri M, Luben RN, Morgan C, et al. . Using lifestyle factors to identify individuals at higher risk of inflammatory polyarthritis (results from the European Prospective Investigation of Cancer-Norfolk and the Norfolk Arthritis Register--the EPIC-2-NOAR Study). Ann Rheum Dis 2014;73:219–26. 10.1136/annrheumdis-2012-202481 PubMed DOI PMC

Fautrel B, Granger B, Combe B, et al. . Matrix to predict rapid radiographic progression of early rheumatoid arthritis patients from the community treated with methotrexate or leflunomide: results from the ESPOIR cohort. Arthritis Res Ther 2012;14:R249. 10.1186/ar4092 PubMed DOI PMC

Psychiatric morbidity in people with autoimmune arthritides as a model of inflammatory mechanisms in mental disorders