Treat to target strategy in early rheumatoid arthritis versus routine care – A comparative clinical practice study
To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA). Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010–2015, were...
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| Veröffentlicht in: | Seminars in arthritis and rheumatism 2019-04, Vol.48 (5), p.808-814 |
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| creator | Brinkmann, Gina Hetland Norvang, Vibeke Norli, Ellen Sauar Grøvle, Lars Haugen, Anne Julsrud Lexberg, Åse Stavland Rødevand, Erik Bakland, Gunnstein Nygaard, Halvor Krøll, Frode Widding-Hansen, Inger Johanne Bjørneboe, Olav Thunem, Cathrine Kvien, Tore Mjaavatten, Maria Dahl Lie, Elisabeth |
| description | To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA).
Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010–2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 |
| doi_str_mv | 10.1016/j.semarthrit.2018.07.004 |
| format | Article |
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Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010–2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 <2.6. These patients were compared to a pre-T2T cohort of patients included in the Norwegian Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) register 2006–2009. Both groups had a clinical diagnosis of RA (≤1 year) and were DMARD naïve. Disease activity and HRQoL outcomes were analysed, and the primary outcome was SDAI remission (≤3.3) at 2years.
The T2T cohort included 293 patients (mean (SD) age 54 (13) years, 66% females, disease duration median (25,75 perc) 98 (57,164) days) and the routine care cohort 392 patients (age 54 (13) years, 68% females, 4 (0,30) days since diagnosis). At 2years, the proportion of patients achieving SDAI remission was 46% in the T2T cohort compared to 31% in the routine care cohort. EQ-5D was similar at baseline, but differed significantly between groups at 2years (median (25,75 perc) 0.77 (0.69, 0.85) vs 0.73 (0.59, 0.80), p < 0.001). Methotrexate monotherapy was the dominant DMARD regimen used to achieve SDAI remission in both cohorts.
Higher remission rates and better HRQoL were achieved in patients following a T2T strategy in clinical practice compared to routine care.</description><identifier>ISSN: 0049-0172</identifier><identifier>EISSN: 1532-866X</identifier><identifier>DOI: 10.1016/j.semarthrit.2018.07.004</identifier><identifier>PMID: 30205983</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Antirheumatic agents ; Prognosis ; Rheumatoid arthritis ; Treatment outcome</subject><ispartof>Seminars in arthritis and rheumatism, 2019-04, Vol.48 (5), p.808-814</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-937ac7d6330e33b7788f6398bc9e8969ceecb2a5e6483e23b0128ff01d7b58973</citedby><cites>FETCH-LOGICAL-c374t-937ac7d6330e33b7788f6398bc9e8969ceecb2a5e6483e23b0128ff01d7b58973</cites><orcidid>0000-0001-8618-0070 ; 0000-0002-8690-2421</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0049017218301847$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30205983$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brinkmann, Gina Hetland</creatorcontrib><creatorcontrib>Norvang, Vibeke</creatorcontrib><creatorcontrib>Norli, Ellen Sauar</creatorcontrib><creatorcontrib>Grøvle, Lars</creatorcontrib><creatorcontrib>Haugen, Anne Julsrud</creatorcontrib><creatorcontrib>Lexberg, Åse Stavland</creatorcontrib><creatorcontrib>Rødevand, Erik</creatorcontrib><creatorcontrib>Bakland, Gunnstein</creatorcontrib><creatorcontrib>Nygaard, Halvor</creatorcontrib><creatorcontrib>Krøll, Frode</creatorcontrib><creatorcontrib>Widding-Hansen, Inger Johanne</creatorcontrib><creatorcontrib>Bjørneboe, Olav</creatorcontrib><creatorcontrib>Thunem, Cathrine</creatorcontrib><creatorcontrib>Kvien, Tore</creatorcontrib><creatorcontrib>Mjaavatten, Maria Dahl</creatorcontrib><creatorcontrib>Lie, Elisabeth</creatorcontrib><title>Treat to target strategy in early rheumatoid arthritis versus routine care – A comparative clinical practice study</title><title>Seminars in arthritis and rheumatism</title><addtitle>Semin Arthritis Rheum</addtitle><description>To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA).
Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010–2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 <2.6. These patients were compared to a pre-T2T cohort of patients included in the Norwegian Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) register 2006–2009. Both groups had a clinical diagnosis of RA (≤1 year) and were DMARD naïve. Disease activity and HRQoL outcomes were analysed, and the primary outcome was SDAI remission (≤3.3) at 2years.
The T2T cohort included 293 patients (mean (SD) age 54 (13) years, 66% females, disease duration median (25,75 perc) 98 (57,164) days) and the routine care cohort 392 patients (age 54 (13) years, 68% females, 4 (0,30) days since diagnosis). At 2years, the proportion of patients achieving SDAI remission was 46% in the T2T cohort compared to 31% in the routine care cohort. EQ-5D was similar at baseline, but differed significantly between groups at 2years (median (25,75 perc) 0.77 (0.69, 0.85) vs 0.73 (0.59, 0.80), p < 0.001). Methotrexate monotherapy was the dominant DMARD regimen used to achieve SDAI remission in both cohorts.
Higher remission rates and better HRQoL were achieved in patients following a T2T strategy in clinical practice compared to routine care.</description><subject>Antirheumatic agents</subject><subject>Prognosis</subject><subject>Rheumatoid arthritis</subject><subject>Treatment outcome</subject><issn>0049-0172</issn><issn>1532-866X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqFkEtqHDEQhkWIiSe2rxC0zKbbJWmmJS0dkxcYsnHAO6FWV9sa-jEpqQdmlzv4hjlJZGaSLLMq-Pkf1McYF1ALEM31tk44espPFHMtQZgadA2wfsVWYqNkZZrm4TVbFcVWILQ8Z29T2gII0YB-w84VSNhYo1Ys3xP6zPPMs6dHzDxl8hkfDzxOHD0NB05PuIw-z7Hjp8mY-B4pLYnTvOQ4IQ-ekP_6-cxveJjHnS8dcV_kIU4x-IHvyIccA5b6pTtcsrPeDwmvTveCff_08f72S3X37fPX25u7Kii9zpVV2gfdNUoBKtVqbUzfKGvaYNHYxgbE0Eq_wWZtFErVgpCm70F0ut0Yq9UFe3_s3dH8Y8GU3RhTwGHwE85LclKAtMJIIYrVHK2B5pQIe7ejWBAfnAD3wtxt3T_m7oW5A-0K4RJ9d1pZ2hG7v8E_kIvhw9GA5dd9RHIpRJwCdpEwZNfN8f8rvwHRoZtF</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Brinkmann, Gina Hetland</creator><creator>Norvang, Vibeke</creator><creator>Norli, Ellen Sauar</creator><creator>Grøvle, Lars</creator><creator>Haugen, Anne Julsrud</creator><creator>Lexberg, Åse Stavland</creator><creator>Rødevand, Erik</creator><creator>Bakland, Gunnstein</creator><creator>Nygaard, Halvor</creator><creator>Krøll, Frode</creator><creator>Widding-Hansen, Inger Johanne</creator><creator>Bjørneboe, Olav</creator><creator>Thunem, Cathrine</creator><creator>Kvien, Tore</creator><creator>Mjaavatten, Maria Dahl</creator><creator>Lie, Elisabeth</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8618-0070</orcidid><orcidid>https://orcid.org/0000-0002-8690-2421</orcidid></search><sort><creationdate>201904</creationdate><title>Treat to target strategy in early rheumatoid arthritis versus routine care – A comparative clinical practice study</title><author>Brinkmann, Gina Hetland ; Norvang, Vibeke ; Norli, Ellen Sauar ; Grøvle, Lars ; Haugen, Anne Julsrud ; Lexberg, Åse Stavland ; Rødevand, Erik ; Bakland, Gunnstein ; Nygaard, Halvor ; Krøll, Frode ; Widding-Hansen, Inger Johanne ; Bjørneboe, Olav ; Thunem, Cathrine ; Kvien, Tore ; Mjaavatten, Maria Dahl ; Lie, Elisabeth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-937ac7d6330e33b7788f6398bc9e8969ceecb2a5e6483e23b0128ff01d7b58973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Antirheumatic agents</topic><topic>Prognosis</topic><topic>Rheumatoid arthritis</topic><topic>Treatment outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brinkmann, Gina Hetland</creatorcontrib><creatorcontrib>Norvang, Vibeke</creatorcontrib><creatorcontrib>Norli, Ellen Sauar</creatorcontrib><creatorcontrib>Grøvle, Lars</creatorcontrib><creatorcontrib>Haugen, Anne Julsrud</creatorcontrib><creatorcontrib>Lexberg, Åse Stavland</creatorcontrib><creatorcontrib>Rødevand, Erik</creatorcontrib><creatorcontrib>Bakland, Gunnstein</creatorcontrib><creatorcontrib>Nygaard, Halvor</creatorcontrib><creatorcontrib>Krøll, Frode</creatorcontrib><creatorcontrib>Widding-Hansen, Inger Johanne</creatorcontrib><creatorcontrib>Bjørneboe, Olav</creatorcontrib><creatorcontrib>Thunem, Cathrine</creatorcontrib><creatorcontrib>Kvien, Tore</creatorcontrib><creatorcontrib>Mjaavatten, Maria Dahl</creatorcontrib><creatorcontrib>Lie, Elisabeth</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Seminars in arthritis and rheumatism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brinkmann, Gina Hetland</au><au>Norvang, Vibeke</au><au>Norli, Ellen Sauar</au><au>Grøvle, Lars</au><au>Haugen, Anne Julsrud</au><au>Lexberg, Åse Stavland</au><au>Rødevand, Erik</au><au>Bakland, Gunnstein</au><au>Nygaard, Halvor</au><au>Krøll, Frode</au><au>Widding-Hansen, Inger Johanne</au><au>Bjørneboe, Olav</au><au>Thunem, Cathrine</au><au>Kvien, Tore</au><au>Mjaavatten, Maria Dahl</au><au>Lie, Elisabeth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treat to target strategy in early rheumatoid arthritis versus routine care – A comparative clinical practice study</atitle><jtitle>Seminars in arthritis and rheumatism</jtitle><addtitle>Semin Arthritis Rheum</addtitle><date>2019-04</date><risdate>2019</risdate><volume>48</volume><issue>5</issue><spage>808</spage><epage>814</epage><pages>808-814</pages><issn>0049-0172</issn><eissn>1532-866X</eissn><abstract>To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA).
Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010–2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 <2.6. These patients were compared to a pre-T2T cohort of patients included in the Norwegian Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) register 2006–2009. Both groups had a clinical diagnosis of RA (≤1 year) and were DMARD naïve. Disease activity and HRQoL outcomes were analysed, and the primary outcome was SDAI remission (≤3.3) at 2years.
The T2T cohort included 293 patients (mean (SD) age 54 (13) years, 66% females, disease duration median (25,75 perc) 98 (57,164) days) and the routine care cohort 392 patients (age 54 (13) years, 68% females, 4 (0,30) days since diagnosis). At 2years, the proportion of patients achieving SDAI remission was 46% in the T2T cohort compared to 31% in the routine care cohort. EQ-5D was similar at baseline, but differed significantly between groups at 2years (median (25,75 perc) 0.77 (0.69, 0.85) vs 0.73 (0.59, 0.80), p < 0.001). Methotrexate monotherapy was the dominant DMARD regimen used to achieve SDAI remission in both cohorts.
Higher remission rates and better HRQoL were achieved in patients following a T2T strategy in clinical practice compared to routine care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30205983</pmid><doi>10.1016/j.semarthrit.2018.07.004</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8618-0070</orcidid><orcidid>https://orcid.org/0000-0002-8690-2421</orcidid></addata></record> |
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| ispartof | Seminars in arthritis and rheumatism, 2019-04, Vol.48 (5), p.808-814 |
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| language | eng |
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| source | Elsevier ScienceDirect Journals |
| subjects | Antirheumatic agents Prognosis Rheumatoid arthritis Treatment outcome |
| title | Treat to target strategy in early rheumatoid arthritis versus routine care – A comparative clinical practice study |
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