Effect of Treat-to-target Strategies Aiming at Remission of Arterial Stiffness in Early Rheumatoid Arthritis: A Randomized Controlled Study

The Journal of Rheumatology
Lydia Ho-Pui TamLai-Shan Tam

Abstract

To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3.3 and Group 2 (n = 60), DAS28 < 2.6. Pulse wave velocity (PWV) and augmentation index (AIx) were measured at baseline and 12 months. A posthoc analysis was also performed to ascertain whether achieving sustained remission could prevent progression in arterial stiffness. The proportions of patients receiving methotrexate monotherapy were significantly lower in Group 1 throughout the study period. At 12 months, the proportions of patients achieving DAS28 and SDAI remission, and the change in PWV and AIx, were comparable between the 2 groups. In view of the lack of differences between the 2 groups, a posthoc analysis was performed at Month 12, including all 110 patients with PWV, to elucidate the independent predictors associated with the change in PWV. Mult...Continue Reading

Associated Clinical Trials

References

Jan 22, 2009·Annals of the Rheumatic Diseases·Y P M Goekoop-RuitermanB A C Dijkmans
Feb 1, 2015·Annals of the Rheumatic Diseases·Elena MyasoedovaCynthia S Crowson
Mar 18, 2015·Arthritis & Rheumatology·D H SolomonJ D Greenberg
May 15, 2015·Annals of the Rheumatic Diseases·Josef S SmolenDesirée van der Heijde
Jun 9, 2015·Translational Research : the Journal of Laboratory and Clinical Medicine·Jiayun ShenLai-Shan Tam

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Citations

Aug 29, 2020·Journal of the American Heart Association·Jack Wilson, Alastair John Stewart Webb
Sep 6, 2020·Current Opinion in Rheumatology·Sofia Serena Tsakali, Catherine M Shanahan

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