Treat-to-target strategy for asian patients with early rheumatoid arthritis: Result of a multicenter trial in Korea

Jason Jungsik Song, Yeong Wook Song, Sang Cheol Bae, Hoon Suk Cha, Jung Yoon Choe, Sungjae Choi, Hyun Ah Kim, Jinseok Kim, Sung Soo Kim, Choong Ki Lee, Jisoo Lee, Sang Heon Lee, Shin Seok Lee, Soo Kon Lee, Sung Won Lee, Sung Hwan Park, Won Park, Seung Cheol Shim, Chang Hee Suh, Bin YooDae Hyun Yoo, Wan Hee Yoo

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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.

Original languageEnglish
Article numbere346
JournalJournal of Korean Medical Science
Volume33
Issue number52
DOIs
Publication statusPublished - 2018 Dec 24

Keywords

  • Rheumatoid arthritis
  • Treat-to-target
  • Treatment outcome

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Song, J. J., Song, Y. W., Bae, S. C., Cha, H. S., Choe, J. Y., Choi, S., Kim, H. A., Kim, J., Kim, S. S., Lee, C. K., Lee, J., Lee, S. H., Lee, S. S., Lee, S. K., Lee, S. W., Park, S. H., Park, W., Shim, S. C., Suh, C. H., ... Yoo, W. H. (2018). Treat-to-target strategy for asian patients with early rheumatoid arthritis: Result of a multicenter trial in Korea. Journal of Korean Medical Science, 33(52), [e346]. https://doi.org/10.3346/jkms.2018.33.e346