TY - JOUR
T1 - Evidence for treating rheumatoid arthritis to target
T2 - results of a systematic literature search update
AU - Stoffer, Michaela A.
AU - Schoels, Monika M.
AU - Smolen, Josef S.
AU - Aletaha, Daniel
AU - Breedveld, Ferdinand C.
AU - Burmester, Gerd
AU - Bykerk, Vivian
AU - Dougados, Maxime
AU - Emery, Paul
AU - Haraoui, Boulos
AU - Gomez-Reino, Juan
AU - Kvien, Tore K.
AU - Nash, Peter T.
AU - Navarro-Compán, Victoria
AU - Scholte-Voshaar, Marieke
AU - van Vollenhoven, Ronald
AU - van der Heijde, Désirée
AU - Stamm, Tanja A.
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
PY - 2016/1
Y1 - 2016/1
N2 - 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.
AB - 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.
KW - Antirheumatic Agents
KW - Arthritis, Rheumatoid
KW - Clinical Trials as Topic
KW - Comorbidity
KW - Evidence-Based Medicine
KW - Humans
KW - Patient Care Planning
KW - Radiography
KW - Severity of Illness Index
KW - Treatment Outcome
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1136/annrheumdis-2015-207526
DO - 10.1136/annrheumdis-2015-207526
M3 - Article
C2 - 25990290
VL - 75
SP - 16
EP - 22
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
IS - 1
ER -