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

Michaela A. Stoffer, Monika M. Schoels, Josef S. Smolen, Daniel Aletaha, Ferdinand C. Breedveld, Gerd Burmester, Vivian Bykerk, Maxime Dougados, Paul Emery, Boulos Haraoui, Juan Gomez-Reino, Tore K. Kvien, Peter T. Nash, Victoria Navarro-Compán, Marieke Scholte-Voshaar, Ronald van Vollenhoven, Désirée van der Heijde, Tanja A. Stamm

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalAnnals of the Rheumatic Diseases
Issue number1
Publication statusPublished - Jan 2016

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