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

Authors
Song, Jason JungsikSong, Yeong WookBae, Sang CheolCha, Hoon-SukChoe, Jung-YoonChoi, Sung JaeKim, Hyun AhKim, JinseokKim, Sung-SooLee, Choong-KiLee, JisooLee, Sang-HeonLee, Shin-SeokLee, Soo-KonLee, Sung WonPark, Sung-HwanPark, WonShim, Seung CheolSuh, Chang-HeeYoo, BinYoo, Dae-HyunYoo, Wan-Hee
Issue Date
24-12월-2018
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Rheumatoid Arthritis; Treatment Outcome; Treat-to-target
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.33, no.52
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
33
Number
52
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/70869
DOI
10.3346/jkms.2018.33.e346
ISSN
1011-8934
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.
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