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Treat-to-target strategy for asian patients with early rheumatoid arthritis: Result of a multicenter trial in Korea

Title
Treat-to-target strategy for asian patients with early rheumatoid arthritis: Result of a multicenter trial in Korea
Authors
Song J.J.Song Y.W.Bae S.C.Cha H.-S.Choe J.-Y.Choi S.J.Kim H.A.Kim J.Kim S.-S.Lee C.-K.Lee J.Lee S.-H.Lee S.-S.Lee S.-K.Lee S.W.Park S.-H.Park W.Shim S.C.Suh C.-H.Yoo B.Yoo D.-H.Yoo W.-H.
Ewha Authors
이지수
SCOPUS Author ID
이지수scopus
Issue Date
2018
Journal Title
Journal of Korean Medical Science
ISSN
1011-8934JCR Link
Citation
Journal of Korean Medical Science vol. 33, no. 52
Keywords
Rheumatoid arthritisTreat-to-targetTreatment outcome
Publisher
Korean Academy of Medical Science
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
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. © 2018 The Korean Academy of Medical Sciences.
DOI
10.3346/jkms.2018.33.e346
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의과대학 > 의학과 > Journal papers
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