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Abstract Number: 2470

Treat to Target: Theoretical Agreement Vs Daily Applicability

Leonardo Romeiro1, Dalton Torigoe2, Claiton Brenol3, Roberto Ranza4, Lícia M. H. Mota5, Manoel Bertolo6, Max Freitas7, José Tupinambá8, Ivanio Pereira9, Lucila Fronza10 and Ieda Maria Magalhães Laurindo11, 1Rheumatology, UNESA, Rio de Janeiro, Rio de Janeiro, Brazil, 2Faculdade de Medicina da Santa Casa de Misericordia, São Paulo, Brazil, 3Rua Cabral, 764 – Apto 302, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 4Reumatologia, Reumatologia, Universidade Federal de Uberlandia, Uberlandia, Brazil, 5Hospital Universitário de Brasília - UnB, Brasília, Brazil, 6INTERNAL MEDICINE, DISCIPLINE OF RHEUMATOLOGY, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil, 7Pathology, Federal University of Ceara, Fortaleza, Brazil, 8Universidade Federal do Piaui, Teresina, Brazil, 9Rheumatology, Universidade do Sul de Santa Catarina, Florianopolis, Brazil, 10CETI - Centro de Estudos em Terapias Inovadoras, Curitiba, Brazil, 11Internal Medicine - Rheumatology, Faculdade de Medicina da Universidade Nove de Julho, São Paulo, Brazil

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Data analysis, Disease Activity, measure, practice improvement and rheumatoid arthritis (RA)

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Session Information

Date: Tuesday, November 15, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster III: Treatment – Monitoring, Outcomes, Adverse Events

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Treat to target (T2T) strategy has been widely recognized as effective and leading to better outcomes. There have been no questions regarding its theoretical bases however its applicability in clinical practice is challenged, particularly when audit researches on patient files are reported. Composite indices of disease activity, cornerstones of T2T strategy, should be regularly applied in therapeutic decision making and readily available. Therefore were  included as desirable but not as a mandatory item in association with a questionnaire dealing with patients perspectives and barriers to T2T implementation while information about social-economical and educational patient´s backgrounds were totally compulsory. The aim of this study was to analyze the availability of composite indices of disease activity and its optional inclusion in a data base with a different focus.

Methods: the data collected by 11 investigators committed to T2T strategy in different areas of the country, in rural and urban settings, in public academic centers and in private practice were reviewed regarding the noncompulsory inclusion of the composite measures of disease activity: DAS28, CDAI e SDAI.

Results: 485 RA patients were included in the database, 86% had DAS28 (mean=3.6±2,33) ;  53.4% SDAI(19.3±22.5) and 59% had CDAI(14.913.5). The percentages of patients with composite indices collected in each center are depicted below as well the percentage of patients in private practice(last column):

 Investigator

DAS28 %

DAS28 mean(SD)

SDAI %

CDAI%

missing public

missing private

Private practice

1 -south/urban

98

3.5(1.6)

80

0.8

0

4

66

2 -south/urban

100

3.8(1.5)

100

100

0

0

68

3 -south/urban

90

3.4(1.3)

0

10

10

0

0

4 -west/urban

96

3.2(1.0)

26

13

4

0

30

5 -southeast/urban

92

3.7(1.4)

86

100

8

0

10

6 -southeast/urban

0

————–

0

0

90

10

10

7 -southeast/rural

85

3.5(1.7)

48

50

6

2

4

8 -southeast/urban

98

3.5(1.3)

66

68

2

4

10

9 -southeast/urban

100

3.8(1.7)

100

100

0

0

36

10- north/urban

100

3.8(1.3)

0

0

0

0

38

11- north/urban

100

3.6(0,9)

0

0

0

0

100

Conclusion: DAS28 was easily obtained in the vast majorities of cases; PCR dosage was the great obstacle to SDAI application. In the absence of laboratory tests CDAI was applied by some investigators. Academic or private settings were not a factor.  


Disclosure: L. Romeiro, None; D. Torigoe, None; C. Brenol, None; R. Ranza, None; L. M. H. Mota, None; M. Bertolo, None; M. Freitas, None; J. Tupinambá, None; I. Pereira, None; L. Fronza, None; I. M. M. Laurindo, None.

To cite this abstract in AMA style:

Romeiro L, Torigoe D, Brenol C, Ranza R, Mota LMH, Bertolo M, Freitas M, Tupinambá J, Pereira I, Fronza L, Laurindo IMM. Treat to Target: Theoretical Agreement Vs Daily Applicability [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/treat-to-target-theoretical-agreement-vs-daily-applicability/. Accessed .
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