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Abstract
Background Treat to Target (T2T) strategy becomes from the need to develop therapeutic targets and tools to achieve defined outcomes in rheumatoid arthritis (RA), this strategy has become recognized as a standard of good practice embodying the principle that rapid attainment of remission, or low disease activity, can halt joint damage and maintain good quality of life. However, there is no direct comparison between biologics in cohorts of patients with long-standing RA using T2T approach in real-life settings, which could have implications in treatment decisions and health economics.
Objectives The aim of this study was to describe global change in Disease Activity Score 28 (DAS28) using T2T strategy for a 5 year period in patients with biological therapy in a large cohort of patients from a Colombian specialized in RA center with multidisciplinary approach.
Methods A descriptive dynamic cohort study was performed. Records of patients using biological DMARD treatment (Anti-TNF and others) from specialized in RA center were reviewed; those patients were followed-up under T2T standards. Clinical follow-up was 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). Therapy had to be adjusted with DAS28 >3.2 unless patient's conditions don't permit it. We divided patients in three groups: low disease activity (LDA), moderate disease activity (MDA) and severe disease activity (SDA) patients. Descriptive epidemiology was done, percentages and averages were calculated; the median of each variable was analyzed using t-Student assuming normality for DAS28 distribution and the level activity disease was analyzed using Pearson's statistics.
Results During 60 month period we included 695 patients with biological therapy, 85% were female and 15% male. Mean age was 58 years ± 11. At beginning mean DAS28 was 4.1±1.1 and 20% of patients were in SDA, and 55% in MDA. At the end of 5 year period mean DAS was 3.2±0.89 and only 7% of patients were in SDA and 33% in MDA. The median was analyzed using t-Student assuming normality for DAS28 distribution. It showed statistical significant improvement (p<0.00).
Conclusions There was a global improvement of DAS28 in a cohort of RA patients receiving biological therapy followed and treated under recommendations of T2T approach demonstrating that with the strategies mentioned above it is possible to obtain a good control of the activity of the disease.
Disclosure of Interest None declared