Cargando…
Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts
INTRODUCTION: Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, although it implementation has varied distinctly in real practices. We report here our investigation of the differences in disease activity and target achievement of two patient...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960103/ https://www.ncbi.nlm.nih.gov/pubmed/35347662 http://dx.doi.org/10.1007/s40744-022-00441-0 |
_version_ | 1784677315623518208 |
---|---|
author | Huang, Hong Xie, Wenhui Geng, Yan Fan, Yong Wang, Yu Zhao, Juan Zhang, Zhuoli |
author_facet | Huang, Hong Xie, Wenhui Geng, Yan Fan, Yong Wang, Yu Zhao, Juan Zhang, Zhuoli |
author_sort | Huang, Hong |
collection | PubMed |
description | INTRODUCTION: Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, although it implementation has varied distinctly in real practices. We report here our investigation of the differences in disease activity and target achievement of two patient cohorts with different T2T implementations. METHODS: Data of the CENTRA (Collaboratively intENsive Treat-to-target in RA) and TARRA (Treat-to-TARget in RA) cohorts were used. The CENTRA cohort is a RA cohort prospectively followed up by a fixed team with tight control, while the TARRA is a longitudinal observational cohort followed up by a rheumatologist with casual control. Patients from the two cohorts were matched 1:3 by propensity score matching. The primary outcome was the Simplified Disease Activity Index (SDAI) at the 1-year follow-up. RESULTS: Included in this analysis were 102 patients from the CENTRA cohort and 271 patients from the TARRA cohort. Both groups were comparable in terms of age, gender, disease course, and seropositivity. At the end of the 1-year follow-up, the SDAI of patients in the CENTRA cohort was significantly lower than that of patients in the TARRA cohort (2.1 vs. 3.4; p < 0.001). A similar result was obtained based on the generalized estimating equation (GEE) model (p = 0.009). In addition, more patients in the CENTRA cohort achieved SDAI-defined remission compared to the TARRA cohort [72 (70.6%) vs. 134 (49.4%); p < 0.001]. CONCLUSION: Patients with RA may benefit more from a tight control T2T strategy with closer follow-up and appropriate education compared with those with a casual T2T strategy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40744-022-00441-0. |
format | Online Article Text |
id | pubmed-8960103 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-89601032022-03-29 Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts Huang, Hong Xie, Wenhui Geng, Yan Fan, Yong Wang, Yu Zhao, Juan Zhang, Zhuoli Rheumatol Ther Original Research INTRODUCTION: Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, although it implementation has varied distinctly in real practices. We report here our investigation of the differences in disease activity and target achievement of two patient cohorts with different T2T implementations. METHODS: Data of the CENTRA (Collaboratively intENsive Treat-to-target in RA) and TARRA (Treat-to-TARget in RA) cohorts were used. The CENTRA cohort is a RA cohort prospectively followed up by a fixed team with tight control, while the TARRA is a longitudinal observational cohort followed up by a rheumatologist with casual control. Patients from the two cohorts were matched 1:3 by propensity score matching. The primary outcome was the Simplified Disease Activity Index (SDAI) at the 1-year follow-up. RESULTS: Included in this analysis were 102 patients from the CENTRA cohort and 271 patients from the TARRA cohort. Both groups were comparable in terms of age, gender, disease course, and seropositivity. At the end of the 1-year follow-up, the SDAI of patients in the CENTRA cohort was significantly lower than that of patients in the TARRA cohort (2.1 vs. 3.4; p < 0.001). A similar result was obtained based on the generalized estimating equation (GEE) model (p = 0.009). In addition, more patients in the CENTRA cohort achieved SDAI-defined remission compared to the TARRA cohort [72 (70.6%) vs. 134 (49.4%); p < 0.001]. CONCLUSION: Patients with RA may benefit more from a tight control T2T strategy with closer follow-up and appropriate education compared with those with a casual T2T strategy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40744-022-00441-0. Springer Healthcare 2022-03-28 /pmc/articles/PMC8960103/ /pubmed/35347662 http://dx.doi.org/10.1007/s40744-022-00441-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Huang, Hong Xie, Wenhui Geng, Yan Fan, Yong Wang, Yu Zhao, Juan Zhang, Zhuoli Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title | Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title_full | Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title_fullStr | Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title_full_unstemmed | Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title_short | Towards a Better Implementation of Treat-to-Target Strategy in Rheumatoid Arthritis: A Comparison of Two Real-World Cohorts |
title_sort | towards a better implementation of treat-to-target strategy in rheumatoid arthritis: a comparison of two real-world cohorts |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960103/ https://www.ncbi.nlm.nih.gov/pubmed/35347662 http://dx.doi.org/10.1007/s40744-022-00441-0 |
work_keys_str_mv | AT huanghong towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT xiewenhui towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT gengyan towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT fanyong towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT wangyu towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT zhaojuan towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts AT zhangzhuoli towardsabetterimplementationoftreattotargetstrategyinrheumatoidarthritisacomparisonoftworealworldcohorts |