Daily practice feasibility and effectiveness of treating long-standing rheumatoid arthritis to target with synthetic disease-modifying antirheumatic drugs: a prospective cohort study

Clinical Rheumatology
Claiton Viegas BrenolRicardo Machado Xavier

Abstract

To prospectively study the daily practice feasibility and effectiveness of treat-to-target (T2T) strategy with synthetic drugs aiming to maintain and achieve disease remission or low activity based on DAS28 and CDAI in long-standing rheumatoid (RA) patients. Two hundred and forty-one consecutive RA patients from Hospital de Clínicas de Porto Alegre were followed for 14 (±5.3) months. At follow-up, patients were evaluated by a rheumatologist at least once every 3 to 4 months. Treatment was adjusted following a step-up strategy, based on the disease activity scores (DAS28 and CDAI), aiming at remission (<2.6 or <2.8, respectively) or at least low disease activity (<3.2 or <10). Patients were predominantly women (84.7 %), mean age 54.9 (±11.9) years with 11.1 (±7.4) years of disease duration. At visit 4, T2T intervention significantly reduced DAS28 (4.6 ± 1.6 vs. 4.0 ± 1.5; p < 0.005), CDAI [17.8 (8.2-28.7) vs. 12.6 (5.1-22.5); p < 0.001], and HAQ (1.5 ± 0.9 vs. 1.3 ± 0.8; p = 0.002). At the end of the study, compared to the baseline scores, more patients achieved remission by DAS28 (11.6 vs. 18.6 %; p < 0.001) and CDAI (8.1 vs. 13.6 %; p < 0.001) and also low disease activity by DAS28 (9.8 vs. 13.0 %; p < 0.001) and CDAI (23.9 vs...Continue Reading

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Citations

May 31, 2016·International Journal of Clinical Practice·J E Machado-AlbaM E Machado-Duque
Apr 6, 2017·Revista Do Instituto De Medicina Tropical De São Paulo·Regina Maia de SouzaValdir Sabbaga Amato
Jan 4, 2017·Revista brasileira de reumatologia·Rafael Mendonça da Silva ChakrRicardo M Xavier
Apr 30, 2017·Seminars in Immunopathology·Tommy Tsang Cheung, Iain B McInnes
Mar 16, 2017·Rheumatology International·Nicole Pamplona Bueno de AndradeClaiton Viegas Brenol
Jul 1, 2021·ClinicoEconomics and Outcomes Research : CEOR·Pedro Santos-MorenoNelson Alvis-Guzmán

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