1735 - 1835 GMT+9
Sunday 29 August
Evening Symposium 4
Learning from evidence and experience to treat Rheumatoid Arthritis
Establishment of 2010 American College of Rheumatology (ACR)/ European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria, development of disease-modifying antirheumatic drugs (DMARDs), that of clinical practice guideline and recommendation, spread of magnetic resonance imaging and ultrasonography have resulted in significant progress regarding to diagnosis as well as therapy of RA. Molecularly targeted drugs, divided into biological DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs, JAK inhibitor), markedly contribute to anti-rheumatic therapy development of RA. Both bDMARDs and JAK inhibitor significantly suppress synovial inflammation as well as joint destruction and are recommended to introduce in clinical practice guideline and recommendation in Phase II in case conventional synthetic DMARDs (csDMARDs) such as MTX and sulfasalazine (Phase I) does not achieve improvement at 3 months and target at 6 months or Phase III bDMARDs or JAK inhibitor does not achieve the goal at 3/6 months, stated in EULAR recommendation (2019 version) and JCR clinical practice guidelines (2020 version). Recent advances have found that the development of RA is a multistep process. The EULAR has identified different phases before the onset of RA, from the presence of genetic and environmental risk factors for RA, towards clinically suspected arthralgia and undifferentiated arthritis. In addition, a new definition of window of opportunity is emerging; this states that the window could even exist in the preclinical phase of RA, preceding diagnosis or fulfillment of classification criteria of RA. However, RA phenotype classification for precision medicine, biomarkers that reflect the effects of anti-rheumatic drugs, evaluation of refractory difficult-to-treat RA, comprehensive RA treatment including treatment costs, precise pre-RA research remains to be elucidated. In this symposium, the recent understanding as well as research challenges for RA will be discussed.
Chair: Prof Won Park, Inha University, South Korea

Remaining Challenges for Rheumatoid Arthritis in Japan
Prof Atsushi Kawakami
Nagasaki University, Japan