Development of rheumatoid arthritis refractory to conventional treatment

Introduction: Early Rheumatoid Arthritis, using the impact of disease onset age on prognostic risk factors, was considered to be poor prognosis factors at a high value of cyclic citrullinate antipeptide antibodies and both high rheumatoid factor (FR) and/or the presence of bone erosions. Objective: To determine the impact of the treatment strategy to achieve and maintain disease-modifying antirheumatic drug-free remission in patients with rheumatoid arthritis. Methods: The search for literature was carried out through a schematic exploration of articles in PubMed and SciELO; original and revision articles published in English and Spanish were considered, using the descriptors, a preliminary reading of the articles was made in order to select those that fit our purpose, the documents that had information with the formal aspects that should be included in the review were chosen, i.e. the rigorous reading of the documents which selected a total of 21 articles. Conclusions: It is at this point that clinical observation has allowed to describe that not all patients do the same course of evolution of the disease, even with standardized treatments worldwide, and in assessing the outcomes of disease it is proposed that there must be particular characteristics of each patient that cause their disease to cause more damage in their evolution comparatively with other patients.