TY - JOUR T1 - Is treat-to-target really working in rheumatoid arthritis? a longitudinal analysis of a cohort of patients treated in daily practice (RA BIODAM) JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 453 LP - 459 DO - 10.1136/annrheumdis-2019-216819 VL - 79 IS - 4 AU - Sofia Ramiro AU - Robert BM Landewé AU - Désirée van der Heijde AU - Alexandre Sepriano AU - Oliver FitzGerald AU - Mikkel Ostergaard AU - Joanne Homik AU - Ori Elkayam AU - J Carter Thorne AU - Margaret Larche AU - Gianfranco Ferraciolli AU - Marina Backhaus AU - Gilles Boire AU - Bernard Combe AU - Thierry Schaeverbeke AU - Alain Saraux AU - Maxime Dougados AU - Maurizio Rossini AU - Marcello Govoni AU - Luigi Sinigaglia AU - Alain G Cantagrel AU - Cornelia F Allaart AU - Cheryl Barnabe AU - Clifton O Bingham AU - Paul P Tak AU - Dirkjan van Schaardenburg AU - Hilde Berner Hammer AU - Rana Dadashova AU - Edna Hutchings AU - Joel Paschke AU - Walter P Maksymowych Y1 - 2020/04/01 UR - http://ard.bmj.com/content/79/4/453.abstract N2 - Objectives To investigate whether following a treat-to-target (T2T)-strategy in daily clinical practice leads to more patients with rheumatoid arthritis (RA) meeting the remission target.Methods RA patients from 10 countries starting/changing conventional synthetic or biological disease-modifying anti-rheumatic drugs were assessed for disease activity every 3 months for 2 years (RA BIODAM (BIOmarkers of joint DAMage) cohort). Per visit was decided whether a patient was treated according to a T2T-strategy with 44-joint disease activity score (DAS44) remission (DAS44 <1.6) as the target. Sustained T2T was defined as T2T followed in ≥2 consecutive visits. The main outcome was the achievement of DAS44 remission at the subsequent 3-month visit. Other outcomes were remission according to 28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI) and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definitions. The association between T2T and remission was tested in generalised estimating equations models.Results In total 4356 visits of 571 patients (mean (SD) age: 56 (13) years, 78% female) were included. Appropriate application of T2T was found in 59% of the visits. T2T (vs no T2T) did not yield a higher likelihood of DAS44 remission 3 months later (OR (95% CI): 1.03 (0.92 to 1.16)), but sustained T2T resulted in an increased likelihood of achieving DAS44 remission (OR: 1.19 (1.03 to 1.39)). Similar results were seen with DAS28-ESR remission. For more stringent definitions (CDAI, SDAI and ACR/EULAR Boolean remission), T2T was consistently positively associated with remission (OR range: 1.16 to 1.29), and sustained T2T had a more pronounced effect on remission (OR range: 1.49 to 1.52).Conclusion In daily clinical practice, the correct application of a T2T-strategy (especially sustained T2T) in patients with RA leads to higher rates of remission. ER -