DOI: https://doi.org/10.36347/sasjm.2025.v11i05.019

Pages: 490-494

Introduction: The new concept of difficult-to-treat rheumatoid arthritis (DaT RA) refers to the recent EULAR definition which describes it by the following three criteria agreed by all members of the working group as mandatory elements of the DaT RA definition: (1) Treatment according to the European League Against Rheumatism (EULAR) recommendation and failure of ≥ 2 biologic disease-modifying antirheumatic drugs (DMARDs)/targeted synthetic DMARDs (with different mechanisms of action) after failure of conventional synthetic DMARD treatment (unless contraindicated); (2) presence of at least one of the following: at least moderate disease activity; signs and/or symptoms suggestive of active disease; inability to taper glucocorticoid therapy; rapid radiographic progression ; RA symptoms leading to reduced quality of life; and (3) the management of signs and/or symptoms is perceived as problematic by the rheumatologist and/or the patient. Our study aims to explore the frequency of this particular entity and to characterise its clinical aspects in a Moroccan population. Patients and Methods: This was a cross-sectional study with retrospective data collection, including all patients with rheumatoid arthritis (RA), meeting the 2010 ACR/EULAR classification criteria for at least one year (from January 2022 to January 2023) in the Rheumatology Department. To analyse the factors associated with RA DaT, we divided our population into two groups: a group designated as RA DaT and a ‘control’ group. Results: Our study included 240 patients, 78 (32.5%) of whom met the ‘EULAR’ definition of RA DaT, with a mean age of 54.6 ± 9.94 years, compared with 56.5 ± 11.5 years, p=0.05 for controls. Rituximab was used in 25.6% of the RA DaT patients in our sample. 45.42% of the PR DaT group received one anti-TNF alpha, 25% of PR DaT received two anti-TNF alpha and 10% of PR DaT received Tocilizumab.