Sustained Beneficial Effects of a Protocolized Treat‐to‐Target Strategy in Very Early Rheumatoid Arthritis: Three‐Year Results of the Dutch Rheumatoid Arthritis Monitoring Remission Induction Cohort

Abstract

Objective. Treat-to-target (T2T) leads to improved clinical outcomes in early rheumatoid arthritis (RA).

Drug-induced toxicity and patient reported outcomes in rheumatoid arthritis patients following intensive treated-to-target strategy: does ceasing therapy due to toxicity worsen outcomes in long term?

“…Health-related quality of life improved significantly from baseline across all domains and summary scores of SF-36. This is consistent with previous studies which demonstrated that a protocolised T2T strategy improves not only disease activity and radiographic outcomes but also long-term HRQoL (24). Greater improvements were observed in physical compared to mental components of HRQoL, which is also consistent with earlier reports (4,6,25).…”

Tight control of disease activity fails to improve body composition or physical function in rheumatoid arthritis patients

“…This improvement in subjectively-assessed function (e.g. HAQ, MDHAQ) with T2T has been widely reported [26,[32][33] and may be due to reductions in pain [25], as pain is known to strongly influence HAQ scores [34][35]46]. This discord between objectively-and subjectively-assessed function in stable RA patients, together with the underestimation RA patients have of their disability, highlights the value of objective function tests and provides further evidence of their greater sensitivity for detecting functional change in patients with well-controlled disease [9,36].…”

Extension Study of Participants from the Trial of Early Aggressive Therapy in Juvenile Idiopathic Arthritis

“…Similar to findings in patients with adult rheumatoid arthritis, early aggressive therapy appears to alter the trajectory of disease 15,16 . Patients with active disease in this TREAT Extension study tended to have low levels of disease activity despite their initial treatment condition.…”