Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Koreaopen access
- Authors
- Song, J.J.[Song, J.J.]; Song, Y.W.[Song, Y.W.]; Bae, S.C.[Bae, S.C.]; Cha, H.-S.[Cha, H.-S.]; Choe, J.-Y.[Choe, J.-Y.]; Choi, S.J.[Choi, S.J.]; Kim, H.A.[Kim, H.A.]; Kim, J.[Kim, J.]; Kim, S.-S.[Kim, S.-S.]; Lee, C.-K.[Lee, C.-K.]; Lee, J.[Lee, J.]; Lee, S.-H.[Lee, S.-H.]; Lee, S.-S.[Lee, S.-S.]; Lee, S.-K.[Lee, S.-K.]; Lee, S.W.[Lee, S.W.]; Park, S.-H.[Park, S.-H.]; Park, W.[Park, W.]; Shim, S.C.[Shim, S.C.]; Suh, C.-H.[Suh, C.-H.]; Yoo, B.[Yoo, B.]; Yoo, D.-H.[Yoo, D.-H.]; Yoo, W.-H.[Yoo, W.-H.]
- Issue Date
- 24-Dec-2018
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Keywords
- Rheumatoid arthritis; Treat-to-target; Treatment outcome
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE, v.33, no.52
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- Volume
- 33
- Number
- 52
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/16342
- DOI
- 10.3346/jkms.2018.33.e346
- ISSN
- 1011-8934
- Abstract
- Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) (2.6 <= DAS28 < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P= 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.
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