Impact of physicians' adherence to treat-to-target strategy on outcomes in early rheumatoid arthritis in the NEO-RACo trial

Scandinavian Journal of Rheumatology
L Kuusalo For The Neo-RACo Study Group

Abstract

It is well recognized that medication adherence of rheumatoid arthritis (RA) patients is often poor. As less attention has been paid to physicians' adherence to targeted treatment, we aimed to investigate how it affects outcomes in aggressively treated early RA patients. In the new Finnish RA Combination Therapy (NEO-RACo) trial, 99 patients with early active RA were treated, targeting remission, with a combination of methotrexate, sulfasalazine, hydroxychloroquine, and low-dose prednisolone for 2 years, and randomized to receive infliximab or placebo for the initial 6 months. After 2 years, therapy was unrestricted while remission was still targeted. Patients were divided into tertiles by physicians' adherence to treat-to-target, which was evaluated with a scoring system during the initial 2 years. After 5 years of follow-up, the between-tertile differences in remission rates, 28-joint Disease Activity Score (DAS28) levels, radiological changes, cumulative days off work, and the use of anti-rheumatic medication were assessed. Follow-up data were available for 93 patients. Physicians' good adherence was associated with improved remission rates at 2-4 years and lower DAS28 levels throughout the follow-up. In a multivariable mode...Continue Reading

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Citations

Dec 25, 2015·Best Practice & Research. Clinical Rheumatology·Sehrash MahmoodRobert Landewé
Sep 22, 2016·Journal of Evaluation in Clinical Practice·Nasir Wabe, Michael D Wiese
Feb 9, 2018·Nature Reviews. Disease Primers·Josef S SmolenKazuhiko Yamamoto
Jul 13, 2019·Zeitschrift für Rheumatologie·C Fiehn, K Krüger
Sep 11, 2019·Journal of Clinical Medicine·Bogdan BatkoZbigniew Żuber
Mar 31, 2016·Current Opinion in Rheumatology·Josef S Smolen
Dec 12, 2018·Journal of Cellular Physiology·Mojtaba AbbasiSaeed Aslani
Apr 30, 2020·Current Rheumatology Reviews·Priya Nijhawan, Tapan Behl

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