Unmet Needs in the Treatment of RA in the Era of Jak-i: IDRA (Italian Delphi Rheumatoid Arthritis) Consensus
Table 5
Answers to the Delphi questionnaire. (Item 9, 10 and 11). The table shows the Delphi questionnaire and the answers relating to the individual items. The answers given by the Delphi participants are expressed in numerical terms. The percentages indicate the sum of the answers related to non-consensus (1, 2) and consensus (3, 4 and 5).
Best condition for an effective mono-therapy
9. In “real life" a high percentage (30-50) of patients that are undergoing combination therapy with bDMARD and methotrexate, only take bDMARD, which leads to an expected reduction in therapeutic efficacy. Therefore to avoid this you would need to:
1
2
3
4
5
9.1 Preferentially use bDMARDs that are effective in monotherapy
1
11
14
14
8
25
75
9.2 Use tsDMARDs preferentially
1
11
17
14
5
25
75
9.3 Choose drugs with lower risk of onset of immunogenicity
1
9
13
19
6
21
79
9.4 Implement follow-up programs even at home
2
6
16
20
4
17
83
Disease remission
10. The “treat to target" approach has been proposed since 2010 for RA patients, with remission as the best treatment outcome possible. However, high heterogeneity in the definitions of disease remission exists in clinical practice. I believe that to achieve complete remission it would be necessary to reach:
1
2
3
4
5
10.1 Clinical remission
1
0
5
9
33
2
98
10.2 Radiological remission (imaging)
0
2
10
10
26
4
96
10.3 Immunological remission
3
9
15
11
10
25
75
11. In clinical practice, the state of the disease evaluation is subjected to various criteria. In assessing clinical remission I rely on:
