{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T14:00:59Z","timestamp":1778076059323,"version":"3.51.4"},"reference-count":24,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100003769","name":"Eisai Co Ltd","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007033","name":"Eisai Korea","doi-asserted-by":"publisher","award":["JYS-IIS-M082-0001"],"award-info":[{"award-number":["JYS-IIS-M082-0001"]}],"id":[{"id":"10.13039\/501100007033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejinme.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Internal Medicine"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1016\/j.ejim.2025.04.040","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T15:50:12Z","timestamp":1746460212000},"page":"96-104","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Difficult-to-treat rheumatoid arthritis among elderly patients from the KOBIO registry"],"prefix":"10.1016","volume":"137","author":[{"given":"Ju-Yang","family":"Jung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunyoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2827-0884","authenticated-orcid":false,"given":"Ji-Won","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-393X","authenticated-orcid":false,"given":"Chang-Hee","family":"Suh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kichul","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-3367","authenticated-orcid":false,"given":"Hyoun-Ah","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"10055","key":"10.1016\/j.ejim.2025.04.040_bib0001","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet"},{"issue":"6","key":"10.1016\/j.ejim.2025.04.040_bib0002","doi-asserted-by":"crossref","DOI":"10.1016\/j.autrev.2020.102528","article-title":"Rheumatoid arthritis in the elderly: characteristics and treatment considerations","volume":"19","author":"Serhal","year":"2020","journal-title":"Autoimmun Rev"},{"issue":"3","key":"10.1016\/j.ejim.2025.04.040_bib0003","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/rheumatology\/38.3.228","article-title":"Does the age of onset of rheumatoid arthritis influence phenotype?: a prospective study of outcome and prognostic factors","volume":"38","author":"Pease","year":"1999","journal-title":"Rheumatology (Oxford)"},{"issue":"11","key":"10.1016\/j.ejim.2025.04.040_bib0004","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1136\/annrheumdis-2019-215920","article-title":"Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017","volume":"78","author":"Safiri","year":"2019","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"10.1016\/j.ejim.2025.04.040_bib0005","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1038\/nrrheum.2013.92","article-title":"The influence of ageing on the development and management of rheumatoid arthritis","volume":"9","author":"Boots","year":"2013","journal-title":"Nat Rev Rheumatol"},{"issue":"3","key":"10.1016\/j.ejim.2025.04.040_bib0006","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0889-857X(05)70154-X","article-title":"Elderly-onset rheumatoid arthritis","volume":"26","author":"Yazici","year":"2000","journal-title":"Rheum Dis Clin North Am"},{"issue":"10","key":"10.1016\/j.ejim.2025.04.040_bib0007","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1080\/14712598.2024.2404521","article-title":"Considerations for the use of biological therapies in elderly patients with rheumatoid arthritis","volume":"24","author":"Nooh","year":"2024","journal-title":"Expert Opin Biol Ther"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0008","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13075-023-03165-w","article-title":"Unveiling difficult-to-treat rheumatoid arthritis: long-term impact of biologic or targeted synthetic DMARDs from the KOBIO registry","volume":"25","author":"Jung","year":"2023","journal-title":"Arthritis Res Ther"},{"issue":"9","key":"10.1016\/j.ejim.2025.04.040_bib0009","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1093\/rheumatology\/keae265","article-title":"Predictive factors and treatment outcomes associated with difficult-to-treat rheumatoid arthritis conditions: the ANSWER cohort study","volume":"63","author":"Watanabe","year":"2024","journal-title":"Rheumatology (Oxford)"},{"issue":"4","key":"10.1016\/j.ejim.2025.04.040_bib0010","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4078\/jrd.22.0005","article-title":"Implications of persistent pain in patients with rheumatoid arthritis despite remission status: data from the KOBIO registry","volume":"29","author":"Kim","year":"2022","journal-title":"J Rheum Dis"},{"key":"10.1016\/j.ejim.2025.04.040_bib0011","article-title":"Difficult-to-treat rheumatoid arthritis: what have we learned and what do we still need to learn?","author":"Hofman","year":"2024","journal-title":"Rheumatology (Oxford)"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0012","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2023-003808","article-title":"Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with 'difficult to treat' rheumatoid arthritis","volume":"10","author":"Bertsias","year":"2024","journal-title":"RMD Open"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0013","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s42358-024-00396-6","article-title":"Characteristics of patients with difficult-to-treat rheumatoid arthritis: a descriptive retrospective cohort study","volume":"64","author":"Qi","year":"2024","journal-title":"Adv Rheumatol"},{"issue":"4","key":"10.1016\/j.ejim.2025.04.040_bib0014","doi-asserted-by":"crossref","first-page":"176","DOI":"10.4078\/jrd.2021.28.4.176","article-title":"KOBIO, the first web-based Korean Biologics Registry operated with a unified platform among distinct disease entities","volume":"28","author":"Kim","year":"2021","journal-title":"J Rheum Dis"},{"issue":"3","key":"10.1016\/j.ejim.2025.04.040_bib0015","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"Arnett","year":"1988","journal-title":"Arthritis Rheum"},{"issue":"9","key":"10.1016\/j.ejim.2025.04.040_bib0016","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0017","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1136\/annrheumdis-2020-217344","article-title":"EULAR definition of difficult-to-treat rheumatoid arthritis","volume":"80","author":"Nagy","year":"2021","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0018","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2022-002842","article-title":"Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease","volume":"9","author":"Leon","year":"2023","journal-title":"RMD Open"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0019","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13075-024-03432-4","article-title":"Obesity and fibromyalgia are associated with difficult-to-treat rheumatoid arthritis (D2T-RA) independent of age and gender","volume":"27","author":"Luciano","year":"2025","journal-title":"Arthritis Res Ther"},{"issue":"2","key":"10.1016\/j.ejim.2025.04.040_bib0020","first-page":"247","article-title":"Retention rate and safety of biologic and targeted synthetic DMARDs in patients with RA-associated interstitial Lung disease: a KOBIO registry study","volume":"37","author":"Lee","year":"2023","journal-title":"BioDrugs"},{"issue":"4","key":"10.1016\/j.ejim.2025.04.040_bib0021","first-page":"691","article-title":"Response to etanercept (Enbrel) in elderly patients with rheumatoid arthritis: a retrospective analysis of clinical trial results","volume":"30","author":"Fleischmann","year":"2003","journal-title":"J Rheumatol"},{"issue":"1","key":"10.1016\/j.ejim.2025.04.040_bib0022","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s40744-018-0101-y","article-title":"Safety, effectiveness, and treatment persistence of Golimumab in elderly patients with rheumatoid arthritis in real-world clinical practice in Japan","volume":"5","author":"Okazaki","year":"2018","journal-title":"Rheumatol Ther"},{"issue":"5","key":"10.1016\/j.ejim.2025.04.040_bib0023","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1093\/rheumatology\/kev437","article-title":"Effectiveness and safety of abatacept in elderly patients with rheumatoid arthritis enrolled in the French Society of Rheumatology's ORA registry","volume":"55","author":"Lahaye","year":"2016","journal-title":"Rheumatology (Oxford)"},{"issue":"9","key":"10.1016\/j.ejim.2025.04.040_bib0024","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1002\/acr.22314","article-title":"Efficacy and safety of rituximab in elderly patients with rheumatoid arthritis enrolled in a French Society of Rheumatology registry","volume":"66","author":"Payet","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"}],"container-title":["European Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0953620525001815?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0953620525001815?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T17:29:52Z","timestamp":1753723792000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0953620525001815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":24,"alternative-id":["S0953620525001815"],"URL":"https:\/\/doi.org\/10.1016\/j.ejim.2025.04.040","relation":{},"ISSN":["0953-6205"],"issn-type":[{"value":"0953-6205","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Difficult-to-treat rheumatoid arthritis among elderly patients from the KOBIO registry","name":"articletitle","label":"Article Title"},{"value":"European Journal of Internal Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejim.2025.04.040","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 European Federation of Internal Medicine. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}