Achievement of Remission in Two Early Rheumatoid Arthritis Cohorts Implementing Different Treat‐to‐Target Strategies
Objective The objective of this study was to compare achievement of remission in 2 early rheumatoid arthritis ( RA ) treat‐to‐target ( TTT ) cohorts, a tight control cohort with a target of stringent remission in a randomized controlled trial and an observational cohort targeting a looser definition...
Published in: | Arthritis & Rheumatology |
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Main Authors: | , , , , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Wiley
2020
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Subjects: | |
Online Access: | http://dx.doi.org/10.1002/art.41232 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fart.41232 https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.41232 https://onlinelibrary.wiley.com/doi/full-xml/10.1002/art.41232 |
Summary: | Objective The objective of this study was to compare achievement of remission in 2 early rheumatoid arthritis ( RA ) treat‐to‐target ( TTT ) cohorts, a tight control cohort with a target of stringent remission in a randomized controlled trial and an observational cohort targeting a looser definition of remission in clinical practice. Methods We analyzed data from the Aiming for Remission in Rheumatoid Arthritis: a randomised trial examining the benefit of ultrasound in a Clinical Tight Control regimen ( ARCTIC ) trial and the Norwegian Very Early Arthritis Clinic ( NOR ‐ VEAC ) observational study. Both were Norwegian multicenter studies that included disease‐modifying antirheumatic drug ( DMARD )–naive RA patients and implemented TTT . The target in the ARCTIC trial was remission defined as a Disease Activity Score ( DAS ) of <1.6 plus 0 swollen joints on a 44‐joint count, while the target in the NOR ‐ VEAC study was the less stringent remission target of a DAS 28 of <2.6. We assessed achievement of the study‐specific targets and compared the odds of achieving the American College of Rheumatology( ACR )/European League Against Rheumatism ( EULAR ) Boolean remission during 2 years of follow‐up. Results We included 189 patients from the ARCTIC trial and 330 patients from the NOR ‐ VEAC study. The study‐specific target had been achieved in more than half of the patients in each cohort at 6 months, increasing to >60% at 12 and 24 months. The odds of achieving ACR / EULAR Boolean remission during follow‐up were higher in the ARCTIC trial than in the NOR ‐ VEAC study, with significant differences at 3 months (odds ratio 1.73 [95% confidence interval 1.03–2.89]), 12 months (odds ratio 1.97 [95% confidence interval 1.21–3.20]), and 24 months (odds ratio 1.82 [95% confidence interval 1.05–3.16]). Conclusion A majority of patients in both cohorts reached the study‐specific treatment targets. More patients in the ARCTIC trial than in the NOR‐VEAC study achieved ACR/EULAR Boolean remission during follow‐up, ... |
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