In a nutshell
This study investigated if a treat-to-target (T2T) strategy achieves remission in rheumatoid arthritis (RA). They found that following a T2T strategy leads to higher remission rates.
Some background
Rheumatoid arthritis (RA) is a chronic condition. Excessive inflammation leads to painful swelling in the joints. RA is treated with drugs to reduce inflammation. These are called disease-modifying anti-rheumatic drugs (DMARDs). The aim of RA treatment is to reduce disease activity (DA). Remission is when a patient has very low DA.
When a doctor is treating an RA patient they aim to lower DA. One strategy is called treat-to-target (T2T). In this case, patients will be treated to achieve remission. With T2T there is strict control of DMARDs. The criteria to adjust DMARD treatment are also stricter. This means if DA starts to increase DMARD treatment is adjusted. Some studies have investigated the effectiveness of T2T. These studies involved controlled clinical trials. It is unclear if a T2T strategy is effective in daily clinical practice.
Methods & findings
This study included 571 patients with RA in daily clinical practice. Patients were treated by their own rheumatologists. A T2T strategy was used over a 2 year period. Patients were assessed every 3 months. DA and remission rates were the main outcomes.
The T2T strategy was adhered to at 59% of follow-up visits. At 3 months, 24% of patients were in remission. At 2 years, 52% of patients were in remission.
The bottom line
The authors concluded that following a T2T strategy leads to higher remission rates in patients with RA.
The fine print
Patients in this study had high DA at the beginning. The effect of T2T on patients with low DA is not clear. Another study in these patients could be useful.
What’s next?
If you have any concerns regarding RA management please consult with your physician.
Published By :
Annals of the rheumatic diseases
Date :
Feb 24, 2020
