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

• Published in: Journal of Korean medical science Vol. 33; no. 52; pp. e346 - 11
• Main Authors: Song, Jason Jungsik, Song, Yeong Wook, Bae, Sang Cheol, Cha, Hoon-Suk, Choe, Jung-Yoon, Choi, Sung Jae, Kim, Hyun Ah, Kim, Jinseok, Kim, Sung-Soo, Lee, Choong-Ki, Lee, Jisoo, Lee, Sang-Heon, Lee, Shin-Seok, Lee, Soo-Kon, Lee, Sung Won, Park, Sung-Hwan, Park, Won, Shim, Seung Cheol, Suh, Chang-Hee, Yoo, Bin, Yoo, Dae-Hyun, Yoo, Wan-Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 24.12.2018; 대한의학회
• Subjects: Adult; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - pathology; Asians; Female; Humans; Male; Middle Aged; Original; Remission Induction; Republic of Korea; Severity of Illness Index; Treatment Outcome; 의학일반; Republic of Korea; Rheumatoid Arthritis; Treat-to-target; Treatment Outcome
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2018.33.e346

To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. 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). 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%; < 0.001; remission, 43.6% vs. 19.8%; < 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%; < 0.001), improved KHAQ scores (-0.38 vs. -0.13; = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; < 0.001). 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.