Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea.
10.3346/jkms.2018.33.e346
- Author:
Jason Jungsik SONG
1
;
Yeong Wook SONG
;
Sang Cheol BAE
;
Hoon Suk CHA
;
Jung Yoon CHOE
;
Sung Jae CHOI
;
Hyun Ah KIM
;
Jinseok KIM
;
Sung Soo KIM
;
Choong Ki LEE
;
Jisoo LEE
;
Sang Heon LEE
;
Shin Seok LEE
;
Soo Kon LEE
;
Sung Won LEE
;
Sung Hwan PARK
;
Won PARK
;
Seung Cheol SHIM
;
Chang Hee SUH
;
Bin YOO
;
Dae Hyun YOO
;
Wan Hee YOO
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Rheumatoid Arthritis;
Treatment Outcome;
Treat-to-target
- MeSH:
Antirheumatic Agents;
Arthritis, Rheumatoid*;
Asian Continental Ancestry Group*;
Demography;
Follow-Up Studies;
Humans;
Joints;
Korea*;
Multicenter Studies as Topic*;
Prescriptions;
Rheumatic Diseases;
Rheumatoid Factor;
Treatment Outcome
- From:Journal of Korean Medical Science
2018;33(52):e346-
- CountryRepublic of Korea
- Language:English
-
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.
