To review the evidence regarding the diagnostic concerns in D2T RA patients for informing the EULAR recommendations for its management in these patients.
No diagnostic tests
to neither confirm nor exclude RA diagnosis nor its impersonating
diseases in patients with difficult-to-treat
rheumatoid arthritis (D2T RA) were found. Ultrasonography was the most
suitable diagnostic test in D2T RA, including those with obesity or
fibromyalgia.
To
review the evidence regarding the diagnostic concerns in D2T RA patients for
informing the EULAR recommendations for its management in these patients.
This
systematic literature review (SLR) was executed concerning the optimal
validation of RA diagnosis and of impersonating diseases and the evaluation of
the activity of the inflammatory disease. PubMed and Embase were explored for
appropriate papers and assessed.
Overall, 82 papers were chosen for detailed
evaluation. An extensive outline of the existing literature concerning the
diagnostic concerns in cases of D2T RA has been presented in this systematic
literature review.
The recognized evidence had numerous
limitations:
No diagnostic test with sufficient validity and precision was identified to define RA diagnosis or connected impersonating disease. To establish inflammatory activity in RA patients and in those with fibromyalgia and obesity, ultrasonography was studied most widely and was designated as the most assuring diagnostic test.
The
lack of high-quality studies concerning diagnostic issues in D2T RA patients
has been emphasized in this review. No diagnostic tests with satisfactory
validity and precision were found to approve nor exclude RA diagnosis nor its
impersonating diseases in D2T RA patients.
RMD Open
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
Nadia M T Roodenrijs et al.
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