The British Rheumatoid Outcome Study Group (BROSG) randomised controlled trial to compare the effectiveness and cost-effectiveness of aggressive versus symptomatic therapy in established rheumatoid arthritis

Abstract

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The clinical effectiveness and cost-effectiveness of treat-to-target strategies in rheumatoid arthritis: a systematic review and cost-effectiveness analysis

“…Six studies 50 52,53 the T-4 study 56,57 and the TEAR trial [58][59][60] ) and six studies 26- 54 and the TEAR trial [58][59][60] ). Two studies 9,35,36,67 made other comparisons which did not seem to fit with any of the above comparisons (i.e. the BROSG trial 9 and the CAMERA trial 35,36,67 ).…”

“…Two studies 9,35,36,67 made other comparisons which did not seem to fit with any of the above comparisons (i.e. the BROSG trial 9 and the CAMERA trial 35,36,67 ). The BROSG trial 9 had two arms: intensive management, which used a DAS44 of ≤ 2.4 target and employed a seven-step treatment protocol based on the target, where patients were seen in a hospital setting; and a routine management arm, which had no target and patients were seen in the community as well as in the clinic, with treatment escalation based on clinical opinion.…”

“…Eleven trials [26][27][28][29][30][31][32][33][34][35][36][38][39][40][41][42][43][44][45][46][47][48][49]51,[54][55][56][57][58][59][60]62,[64][65][66][67] examined an early RA population (defined as disease duration of < 3 years; see Chapter 4, Inclusion and exclusion criteria) [i.e. BehandelStrategieën in Reumatoïde Artritis (BeSt), 26- 55 the TreaTing to Twin Targets (T-4) study, 56,57 the Treatment of Early Aggressive Rheumatoid arthritis (TEAR) trial [58][59][60] and the early rheumatoid arthritis treated with tocilizumab, methotrexate or their combination (U-Act-Early) trial 62 ], three trials 9,50,52,53 examined an established RA population [i.e. British Rheumatoid Outcome Study Group (BROSG) trial, 9 Fransen et al 50 and the Optimisation of Adalimumab study 52,53 ] and two trials 61,63 examined populations that i...…”

“…BehandelStrategieën in Reumatoïde Artritis (BeSt), 26- 55 the TreaTing to Twin Targets (T-4) study, 56,57 the Treatment of Early Aggressive Rheumatoid arthritis (TEAR) trial [58][59][60] and the early rheumatoid arthritis treated with tocilizumab, methotrexate or their combination (U-Act-Early) trial 62 ], three trials 9,50,52,53 examined an established RA population [i.e. British Rheumatoid Outcome Study Group (BROSG) trial, 9 Fransen et al 50 and the Optimisation of Adalimumab study 52,53 ] and two trials 61,63 examined populations that include both patients with early RA and those with established RA [i.e. the TIght COntrol for RA (TICORA) trial 61 examined patients with a disease duration of < 5 years and van Hulst et al 63 reported including both newly diagnosed patients and those with established disease (and did not report on the findings for these patients separately at all)].…”

Development of the American College of Rheumatology's Rheumatoid Arthritis Electronic Clinical Quality Measures

“…Evidence consists of important clinical trials of different treat-to-target strategies anchored on disease activity assessments showing better RA outcomes in the treat-to-target groups (12)(13)(14)(15). Additionally, in an observational study involving 1,297 individuals, achievement of recommended disease targets was associated with improved physical function, health-related quality-of-life, and reduced hospitalizations (16).…”