„Treat-to-Target“ (T2T) aus der Sicht der stationären Rheumatologie

Abstract

Publication of the treat-to-target (T2T) concept at the end of the Bone and Joint Decade almost coincided with the 15 treatment recommendations of the EULAR as well as with the new classification and revised remission criteria for rheumatoid arthritis (RA).The treat-to-target initiative is solely focused on the description of benchmarks for an effective treatment management of RA to reach its priority target of remission.From the perspective of inpatient rheumatology parallels are shown to the quality projects of the Association of Rheumatology Clinics (VRA), which were initiated in 2001 for the first time.The quality management started up by the VRA not only benefited from the development of the German diagnosis-related groups (G-DRG) system which was also supported by the VRA and the German Society of Rheumatology (DGRh) but also from projects realized to improve the structural and operational quality in inpatient rheumatology units.By launching its own outcome benchmarking project (OBRA) in 2003, which was financially supported by the German Ministry of Health and its continuation with Kobra-1 and future Kobra-2, the VRA already successfully incorporated all benchmarks of management guidelines outlined in the T2T initiative.By steadily improving the outcome, even of RA patients, inpatient rheumatology offers a special quality project for participating clinics who are otherwise competitors, not only to learn from each other but to support each other to find the best way (T2T) to reach a remission and a good quality of life for RA patients and patients with other systemic rheumatic diseases.

Anti-TNF Agents as Therapeutic Choice in Immune-Mediated Inflammatory Diseases: Focus on Adalimumab

“…Over expression of tumour necrosis factor (TNF) has been shown to play a dominant role in the pathogenesis of various IMIDs, such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), Crohn's disease, ulcerative colitis (UC), psoriasis and psoriatic arthritis (PsA). In addition to evidence from mechanistic studies, pointing out the common pathogenesis and role ofTNF among IMlDs, findings from epidemiological and genetic studies support the theory that IMlDs are related disorders, with a common genetic susceptibility, thus explaining the co-occurrence or 'genetic overlap' and familial patterns of these diseases (2)(3)(4)(5)(6).…”

“…In addition to evidence from mechanistic studies, pointing out the common pathogenesis and role ofTNF among IMlDs, findings from epidemiological and genetic studies support the theory that IMlDs are related disorders, with a common genetic susceptibility, thus explaining the co-occurrence or 'genetic overlap' and familial patterns of these diseases (2)(3)(4)(5)(6). In addition to evidence from mechanistic studies, pointing out the common pathogenesis and role ofTNF among IMlDs, findings from epidemiological and genetic studies support the theory that IMlDs are related disorders, with a common genetic susceptibility, thus explaining the co-occurrence or 'genetic overlap' and familial patterns of these diseases (2)(3)(4)(5)(6).…”

Centers of Excellence Implementation for Treating Rheumatoid Arthritis in Colombia: A Cost-Analysis

“…Among them are the diagnosis-related groups, Pay for Performance (P4P) and CoE that apply the T2T strategy for RA based on PCC model. 33 Previous evidence has shown that involving the patient as an individual with unique needs, concerns and preferences has an important impact on safety, effectiveness and costs. 34 Our results prove that the CoE strategy would have great impact in terms of public policies for the treatment of RA in Colombia.…”