Background The importance of early effective therapy, implications of disease activity in progression and use of composite disease activity measures in rheumatoid arthritis (RA), led to developing of defined therapeutic targets and tools to achieve them resulting in the Treat to Target (T2T) initiative. This strategy is being used last 2 years in Colombia in a specialized in RA center.
Objectives The aim of this study was to describe global change in Disease Activity Score 28 (DAS28) using T2T strategy for a 24 month period in a large cohort of patients from a Colombian specialized in RA center.
Methods A descriptive cross-sectional study was performed. Records of patients from specialized in RA center were reviewed; those patients were followed-up under T2T standards. Clinical follow-up was designed by the authors according to DAS28 as follows: every 3-5 weeks (DAS28 >5.1), every 7-9 weeks (DAS28 ≥3.1 and ≤5.1), and every 11-13 weeks (DAS28 <3.1). In case of DAS28 >3.2 it was mandatory to introduce adjustments in treatment based on a predetermined clinical guideline. We calculated percentages and averages from this data and distributed patients in four groups: remission (Rem), low disease activity (LDA), moderate disease activity (MDA) and severe disease activity (SDA). Global change in DAS28 was determined at beginning, 6, 12, and 24 months an assessed using Chi-square test. The median of each variable was analyzed using t-Student assuming normality for DAS28 distribution and the level of disease activity was analyzed using Pearson's statistics.
Results 1046 patients were included in this study, 865 (82.7%) women and 181 (17.3%) men. Mean age 60.1 years. With regard to treatment it was found that 340 (32.5%) patients were treated with biologics, and 706 (67.5%) patients with conventional therapy. The mean of DAS28 was 3.4 at the beginning and 24 months after was 2.6. The difference of medians for each variable showed improvement with statistical significance (p<0.00).
Conclusions This study shows improvement of DAS28 in a cohort of RA patients from a specialized center in Colombia treated under recommendations of T2T strategy; it was found a global increase in the percentage of patients in remission (REM) and decrease in moderate and severe disease activity (MDA/SDA) group. This study shows de importance of T2T strategy for following-up and treating this disease.
Disclosure of Interest None declared