Gina Hetland Brinkmann1, Vibeke Norvang2, Ellen Sauar Norli3, Lars Grøvle4, Anne Julsrud Haugen4, Åse Stavland Lexberg5, Erik Rødevand6, Gunnstein Bakland7, Halvor Nygaard8, Frode Krøll8, Inger Johanne Widding-Hansen9, Olav Bjørneboe10, Cathrine Thunem11, Tore Kvien2, Maria Dahl Mjaavatten2, Elisabeth Lie2. 1. Department of Rheumatology, Østfold Hospital Trust, Postbox 300, N-1714 Grålum, Norway; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; The University of Oslo, Oslo, Norway. Electronic address: gina_hetland@hotmail.com. 2. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. 3. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Martina Hansen Hospital, Bærum, Norway. 4. Department of Rheumatology, Østfold Hospital Trust, Postbox 300, N-1714 Grålum, Norway. 5. Department of Rheumatology, Vestre Viken Hospital Trust, Drammen, Norway. 6. Department of Rheumatology, St.Olavs Hospital, University Hospital of Trondheim, Norway. 7. Department of Rheumatology, University Hospital of North Norway, Tromsø, Norway. 8. Department of Rheumatology, Lillehammer Hospital for Rheumatic diseases, Lillehammer, Norway. 9. Department of Rheumatology, Hospital of Southern Norway Trust, Kristiansand, Norway. 10. Department of Rheumatology, Martina Hansen Hospital, Bærum, Norway. 11. Department of Rheumatology, Betanien Hospital, Skien, Norway.
Abstract
OBJECTIVE: To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA). METHODS: Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010-2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 <2.6. These patients were compared to a pre-T2T cohort of patients included in the Norwegian Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) register 2006-2009. Both groups had a clinical diagnosis of RA (≤1 year) and were DMARD naïve. Disease activity and HRQoL outcomes were analysed, and the primary outcome was SDAI remission (≤3.3) at 2years. RESULTS: The T2T cohort included 293 patients (mean (SD) age 54 (13) years, 66% females, disease duration median (25,75 perc) 98 (57,164) days) and the routine care cohort 392 patients (age 54 (13) years, 68% females, 4 (0,30) days since diagnosis). At 2years, the proportion of patients achieving SDAI remission was 46% in the T2T cohort compared to 31% in the routine care cohort. EQ-5D was similar at baseline, but differed significantly between groups at 2years (median (25,75 perc) 0.77 (0.69, 0.85) vs 0.73 (0.59, 0.80), p < 0.001). Methotrexate monotherapy was the dominant DMARD regimen used to achieve SDAI remission in both cohorts. CONCLUSION: Higher remission rates and better HRQoL were achieved in patients following a T2T strategy in clinical practice compared to routine care.
OBJECTIVE: To assess the 2-year effect on disease activity and health-related quality of life (HRQoL) of implementing a clinical practice treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA). METHODS:Patients in the Norwegian Very Early Arthritis Cohort 2.0 (NOR-VEAC 2.0), included 2010-2015, were treated according to T2T principles with visits at baseline, 3, 6, 9, 12 months, then every 6 months plus monthly visits until DAS28 <2.6. These patients were compared to a pre-T2T cohort of patients included in the Norwegian Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) register 2006-2009. Both groups had a clinical diagnosis of RA (≤1 year) and were DMARD naïve. Disease activity and HRQoL outcomes were analysed, and the primary outcome was SDAI remission (≤3.3) at 2years. RESULTS: The T2T cohort included 293 patients (mean (SD) age 54 (13) years, 66% females, disease duration median (25,75 perc) 98 (57,164) days) and the routine care cohort 392 patients (age 54 (13) years, 68% females, 4 (0,30) days since diagnosis). At 2years, the proportion of patients achieving SDAI remission was 46% in the T2T cohort compared to 31% in the routine care cohort. EQ-5D was similar at baseline, but differed significantly between groups at 2years (median (25,75 perc) 0.77 (0.69, 0.85) vs 0.73 (0.59, 0.80), p < 0.001). Methotrexate monotherapy was the dominant DMARD regimen used to achieve SDAI remission in both cohorts. CONCLUSION: Higher remission rates and better HRQoL were achieved in patients following a T2T strategy in clinical practice compared to routine care.
Authors: Peter M Ten Klooster; Martijn A H Oude Voshaar; Walid Fakhouri; Inmaculada de la Torre; Claudia Nicolay; Mart A F J van de Laar Journal: Clin Rheumatol Date: 2019-06-03 Impact factor: 2.980
Authors: Vibeke Norvang; Espen A Haavardsholm; Sara K Tedeschi; Houchen Lyu; Joseph Sexton; Maria D Mjaavatten; Tore K Kvien; Daniel H Solomon; Kazuki Yoshida Journal: BMC Med Res Methodol Date: 2022-05-28 Impact factor: 4.612
Authors: Lucie Nekvindová; Jiří Vencovský; Karel Pavelka; Pavel Horák; Zlatuše Křístková; Jakub Závada Journal: Arthritis Res Ther Date: 2021-01-06 Impact factor: 5.156
Authors: Kari Guderud; Line H Sunde; Siri T Flåm; Marthe T Mæhlen; Maria D Mjaavatten; Ellen S Norli; Ida M Evenrød; Bettina K Andreassen; Sören Franzenburg; Andre Franke; Simon Rayner; Kristina Gervin; Benedicte A Lie Journal: Front Immunol Date: 2021-11-18 Impact factor: 7.561