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

Authors
 Jason Jungsik Song  ;  Yeong Wook Song  ;  Sang Cheol Bae  ;  Hoon-Suk Cha  ;  Jung-Yoon Choe  ;  Sung Jae Choi  ;  Hyun Ah Kim  ;  Jinseok Kim  ;  Sung-Soo Kim  ;  Choong-Ki Lee  ;  Jisoo Lee  ;  Sang-Heon Lee  ;  Shin-Seok Lee  ;  Soo-Kon Lee  ;  Sun Won Lee  ;  Sung-Hwan Park  ;  Won Park  ;  Seung Cheol Shim  ;  Chang-Hee Suh  ;  Bin Yoo  ;  Dae-Hyun Yoo  ;  Wan-Hee Yoo 
Citation
 Journal of Korean Medical Science, Vol.33(52) : e346, 2018 
Journal Title
 Journal of Korean Medical Science 
ISSN
 1011-8934 
Issue Date
2018
Keywords
Rheumatoid Arthritis ; Treat-to-target ; Treatment Outcome
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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DOI
10.3346/jkms.2018.33.e346
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
송정식(Song, Jungsik Jason) ORCID logo https://orcid.org/0000-0003-0662-7704
이수곤(Lee, Soo Kon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167148
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