A tight control treatment strategy aiming for remission in early rheumatoid arthritis is more effective than usual care treatment in daily clinical practice: a study of two cohorts in the Dutch Rheumatoid Arthritis Monitoring registry

Abstract

In early RA, a tight control treatment strategy aiming for remission leads to more rapid DAS28 remission and higher percentages of remission after 1 year than does a usual care treatment.

Sustained Beneficial Effects of a Protocolized Treat‐to‐Target Strategy in Very Early Rheumatoid Arthritis: Three‐Year Results of the Dutch Rheumatoid Arthritis Monitoring Remission Induction Cohort

“…Third, our results reflect the effects of only one medication strategy; no comparator was included. Recently, we compared the short-term results of our cohort with a comparable cohort in which usual care treatment was applied, demonstrating that T2T had superiority (12).…”

“…T2T entails a treatment strategy tailored to the disease activity of the individual RA patient with the aim of achieving a predefined level of low disease activity or remission. The Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort demonstrated that remission is a realistic goal in daily clinical practice with the application of a T2T strategy aimed at remission according to the Disease Activity Score in 28 joints (DAS28) (11), with early and intensive treatment leading to high remission rates (12) and limited radiographic progression after 1 year of followup (13). The question is whether these beneficial results sustain in the long term.…”

Implementación de una unidad de artritis reumatoide temprana en pacientes chilenos derivados desde centros de atención primaria de salud

“…Un modelo sanitario que gestione diagnósticos tempranos con la consecuente introducción precoz de la terapia permite obtener beneficios entre los cuales se cuentan el reducir significativamente la progresión y el daño crónico, interrumpir el daño articular y mejorar las tasas de remisión libre de drogas 9,10 . Pacientes con una intervención terapéutica temprana tienen 33% menos de progresión radiológica comparado con aquellos que recibieron tratamiento "tardía-mente", incluso cuando se considera a individuos con menos de dos años de enfermedad 6 .…”

Cost-effectiveness of biologic treatment for rheumatoid arthritis in clinical practice: An achievable target?

“…Besides early treatment of RA to optimise the use of biologics, tight control of the disease is important [57], [58] and [59]. Indeed, this makes it possible to more easily achieve good clinical response, remission, prevention of anatomical lesions and swifter recovery of the functional limitations in a short time.…”