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Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes pain, swelling, and stiffness in the joints. It can also cause fatigue, and the underlying inflammation may affect other body systems. A significant proportion of people with rheumatoid arthritis (RA) still have symptoms despite receiving treatment according to the current management recommendations. These people can be considered to have 'difficult-to-treat RA." However, there is no uniform terminology or definitions to decide when this applies. The concept is referred to by many different terms, including severe, refractory, drug-resistant, or established RA. EULAR prefer the term 'difficult-to-treat' because it best capture the possible clinical scenarios. Being clear on terminology is important because people with difficult-to-treat RA may require a different approach.