Bit of a necro...
I too have been suffering from severe performance issues with Radeon RX5700 XT. I have been using d912pxy to make the game somewhat playable, but not really happy with that solution. Inspired by some other forums and Youtube-videos I tried running the game with DX9 libraries and what a difference. Everything runs silky smooth, no sign of the stuttering and poor refresh rate.
So steps I took:
1. Download and install DX9 standalone from Microsoft. NOTE! You still need to run the installer after you extract files from the downloaded package. (do not trust random download sources) http://www.microsoft.com/en-us/download/confirmation.aspx?id=8109
2. Add "-force-d3d9" to the game launcher target. So it should be something like ("...\Guild Wars 2\Gw2-64.exe" -force-d3d9)
3. Remember to uninstall d912pxy or similar if you have it installed
(OPTIONAL):
* Run this program as Administrator
* Disable fullscreen optimizations
I have not done any extensive testing but so far things look very promising.