Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update.

Abstract:

OBJECTIVE:A systematic literature review (SLR; 2009-2014) to compare a target-oriented approach with routine management in the treatment of rheumatoid arthritis (RA) to allow an update of the treat-to-target recommendations. METHODS:Two SLRs focused on clinical trials employing a treatment approach targeting a specific clinical outcome were performed. In addition to testing clinical, functional and/or structural changes as endpoints, comorbidities, cardiovascular risk, work productivity and education as well as patient self-assessment were investigated. The searches covered MEDLINE, EMBASE, Cochrane databases and Clinicaltrial.gov for the period between 2009 and 2012 and separately for the period of 2012 to May of 2014. RESULTS:Of 8442 citations retrieved in the two SLRs, 176 articles underwent full-text review. According to predefined inclusion/exclusion criteria, six articles were included of which five showed superiority of a targeted treatment approach aiming at least at low-disease activity versus routine care; in addition, publications providing supportive evidence were also incorporated that aside from expanding the evidence provided by the above six publications allowed concluding that a target-oriented approach leads to less comorbidities and cardiovascular risk and better work productivity than conventional care. CONCLUSIONS:The current study expands the evidence that targeting low-disease activity or remission in the management of RA conveys better outcomes than routine care.

journal_name

Ann Rheum Dis

authors

Stoffer MA,Schoels MM,Smolen JS,Aletaha D,Breedveld FC,Burmester G,Bykerk V,Dougados M,Emery P,Haraoui B,Gomez-Reino J,Kvien TK,Nash P,Navarro-Compán V,Scholte-Voshaar M,van Vollenhoven R,van der Heijde D,Stamm TA

doi

10.1136/annrheumdis-2015-207526

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

16-22

issue

1

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2015-207526

journal_volume

75

pub_type

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