类风湿性关节炎（RA）患者和风湿病学家面临的真正挑战是对各种治疗的初次非反应性（PNRS）或次级非反应性（SNRS）。尽管它们对患者生活质量产生不利影响，但PNRS和SNRS没有准确的定义，也没有早期预测其发展的标准。 RA患者40岁以下较少，因此该年龄组关于PNRS和SNRS的数据较少。本研究考察了根据性别、年龄、BMI、治疗类型和疗程的PNRS和SNRS。回顾性研究将115例有PNRS和/或SNRS的RA患者按年龄分层（22-39岁、40-59岁和60-81岁）。研究了体重指数（BMI）、前炎性细胞因子抑制剂、JAK抑制剂和TNF-α抑制剂、性别、年龄与PNRS和SNRS之间的关系。三种前炎性细胞因子抑制剂（利妥昔单抗、托珠单抗和阿巴塞普）与40-59岁年龄组肥胖女性的PNRS和SNRS有关。在BMI正常的60-81岁女性中，阿巴塞普相关的PNRS和SNRS显著。阿达木单抗、英夫利昔单抗和戈利昂抑制了22-39岁BMI正常女性和60-81岁BMI高的女性的SNRS。依那西普和英夫利昔单抗与40-59岁高BMI男性的SNRS状态有关。PNRS和SNRS在RA患者中的发展受到年龄、性别和BMI的显著影响，但更重要的是与治疗类型和疗程密切相关而且有所不同。版权所有©2023，国际抗癌研究院（George J. Delinasios博士），保留所有权利。

A real challenge for patients with rheumatoid arthritis (RA) and rheumatologists is primary nonresponse status (PNRS) or secondary nonresponse status (SNRS) to various therapies. Despite their detrimental influence on patient life quality, PNRS and SNRS have no accurate definition and no early predictive criteria for their development exist. Patients with RA under 40 years of age are rare, hence PNRS and SNRS data for this age group are scarce. This study examined the PNRS and SNRS according to sex, age, BMI, therapy type, and duration.Retrospectively, 115 patients with RA having PNRS and/or SNRS were stratified by age (22-39, 40-59, and 60-81). The association between body mass index (BMI), proinflammatory cytokines inhibitors, JAK inhibitors, and TNF-alpha inhibitors, sex, age, and PNRS and SNRS was examined.All three proinflammatory cytokine inhibitors (rituximab, tocilizumab, and abatacept) were associated with PNRS and SNRS in women with a high BMI aged 40-59 years. Abatacept-related PNRS and SNRS was significant in women with normal BMI aged 60-81 years. Adalimumab, infliximab, and golimumab affected SNRS differently in women with normal BMI aged 22-39 years and women with high BMI aged 60-81 years. Etanercept and infliximab were associated with SNRS status in men with high-BMI aged 40-59 years.PNRS and SNRS development in patients with RA is significantly influenced by age, sex, and BMI, but most importantly is closely and differentially related to therapy type and duration.Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.