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Background: Difficult-to-treat Rheumatoid arthritis (D2T RA) is primarily characterised by failure of at least two different mechanism of action biologic/targeted synthetic disease-modifying antirheumatic drug (DMARDs) with evidence of active/progressive disease. While a variety of drugs have been used in previous studies to treat D2T RA, there has been no systematic summary of these drugs. This study conducted a systematic review of randomized controlled trials aimed at analyzing the efficacy and safety of individual therapeutic agents for the treatment of D2T RA and recommending the optimal therapeutic dose. Methods: The English databases were searched for studies on the treatment of D2T RA published between the date of the database's establishment and March, 2024. This study uses R 3.1.2 for data analysis, and the rjags package runs JAGS 3.4.0.20. The study fitted a stochastic effects Bayesian network meta-analysis for each outcome measure. Result: A total of 42 studies were included in this study. Compared with placebo, the improvement of Disease Activity Score of 28 Joints (DAS28) score is ranked from high to low as tocilizumab, baricitinib and opinercept. The improvement of American College of Rheumatology 50 response (ACR50) score in patients with drug use was ranked from good to poor as follows: olokizumab, tocilizumab, adalimumab, baricitinib, and upadacitinib, and 8 mg/4w tocilizumab demonstrated the best efficacy. Notably, rituximab is generally the safest drug. Janus kinase (JAK) inhibitors and T cell costimulation modulators are effective in D2T RA refractory to biologic DMARDs, while JAK inhibitors and interleukin-6 (IL-6) inhibitors show effectiveness in D2T RA refractory to csDMARDs. Conclusion: Tocilizumab and rituximab have better efficacy and safety in the treatment of D2T RA, and the 8 mg/4w dose of tocilizumab may be the first choice for achieving disease remission. [ABSTRACT FROM AUTHOR]

In this report, two diiron ethane-1,2-dithiolate carbonyl complexes with bridging 1,3-bis(diphenylphosphino)propane (dppp) or tris(3-fluorophenyl)phosphine have been synthesized and characterized. Treatment of complex [Fe2(CO)6(µ-SCH2CH2S)] (1) with a diphosphine ligand dppp or a monophosphine ligand tris(3-fluorophenyl)phosphine using Me3NO·2H2O as the decarbonylating reagent afforded the corresponding derivatives [{Fe2(CO)5(µ-SCH2CH2S)}2(Ph2PCH2CH2CH2PPh2)] (2) and [Fe2(CO)5(µ-SCH2CH2S){P(3-C6H4F)3}] (3) in 82% and 92% yields, respectively. Complexes 2 and 3 have been characterized by elemental analysis, IR, NMR spectroscopy, as well as confirmed by single crystal X-ray diffraction analysis. Moreover, the electrochemistry of these complexes were studied by cyclic voltammetry. [ABSTRACT FROM AUTHOR]

Two diiron ethane-1,2-dithiolate complexes were prepared and structurally characterized. Reactions of the parent complex [Fe2(CO)6(μ-SCH2CH2S)] (1) with tris(4-trifluoromethylphenyl)phosphine or triethyl phosphite and Me3NO·2H2O as the oxidative reagent resulted in the formation of the phosphine-substituted analog [Fe2(CO)5{P(4-C6H4CF3)3}(μ-SCH2CH2S)] (2) and phosphite-substituted analogue [Fe2(CO)5{P(OCH2CH3)3}(μ-SCH2CH2S)] (3) in 84% and 78% yields, respectively. The new complexes 2 and 3 were characterized by elemental analysis, IR, NMR spectroscopy, and single crystal X-ray diffraction analysis. Moreover, the electrochemical properties of both complexes were studied by cyclic voltammetry. [ABSTRACT FROM AUTHOR]

Two diiron toluene-3,4-dithiolate complexes with a phosphine ligand or a phosphite ligand were prepared and characterized. Treatment of complex [Fe2(CO)6{µ-SC6H3(CH3)S}] (1) with one equivalent of ethyldiphenylphosphine or methyldiphenylphosphinite and the decarbonylation agent Me3NO·2H2O gave analogues [Fe2(CO)5(Ph2PCH2CH3){µ-SC6H3(CH3)S}] (2) [Fe2(CO)5(Ph2POCH3){µ-SC6H3(CH3)S}] (3) and in 84% and 61% yields, respectively. Both analogues have been characterized by spectroscopy, elemental analysis, and X-ray crystallography. The electrochemical properties were probed by cyclic voltammetry. [ABSTRACT FROM AUTHOR]

We report a novel diiron propane-1,3-dithiolate complex [Fe2(CO)5PH(C10H15)2(μ-SCH2CH2CH2S)] containing a di-1-adamantylphosphine ligand. Trimethylamine N-oxide-induced decarbonylation of complex [Fe2(CO)6(μ-SCH2CH2CH2S)] followed by reaction with di-1-adamantylphosphine yielded the target product in 86% yield. The title compound was identified by spectroscopy, elemental analysis, as well as further determined by single crystal X-ray diffraction analysis. Electrochemical properties were studied by cyclic voltammetry without or with HOAc. Interestingly, the fungicidal activity of the title compound showed moderate activity against Phytophthora infestans, Pyricularia oryae, Botrytis cinerea, and Physalospora piricola. [ABSTRACT FROM AUTHOR]