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Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

Authors :
Dae Hyun Yoo
Sang Cheol Bae
Hyun Ah Kim
Choong Ki Lee
Jason Jungsik Song
Chang Hee Suh
Wan Hee Yoo
Shin-Seok Lee
Jisoo Lee
Sung Won Lee
Jinseok Kim
Sang-Heon Lee
Jung Yoon Choe
Sung-Soo Kim
Won Park
Soo Kon Lee
Sung Jae Choi
Seung Cheol Shim
Yeong Wook Song
Bin Yoo
Hoon Suk Cha
Sung Hwan Park
Source :
Journal of Korean Medical Science
Publication Year :
2018
Publisher :
The Korean Academy of Medical Sciences, 2018.

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.<br />Graphical Abstract

Details

Language :
English
ISSN :
15986357 and 10118934
Volume :
33
Issue :
52
Database :
OpenAIRE
Journal :
Journal of Korean Medical Science
Accession number :
edsair.doi.dedup.....84fad7e3386b7dc1e94d91d6f28a9649