Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: To assess the implementation of the treat to target (T2T) concept in rheumatoid arthritis (RA) patients.
Methods: Academic rheumatology units were invited to participate in a retrospective study evaluating the implementation of the T2T concept in RA patients. The charts of consecutive RA patients attending the centers during June 2015, with 3 or more previous visits, were evaluated using a common questionnaire. Data collected included demographic parameters, alcohol consumption, smoking, concomitant diseases, age at RA onset, and the presence of rheumatoid factor (RF) and erosions. Validated disease activity scores [Disease Activity Score (DAS-28), Clinical Disease Activity Index (CDAI), Simple Disease Activity Index (SDAI), Routine Assessment of Patient Index Data (RAPID3)], RA treatment including conventional or biological DMARDS, drug dosages, side effects, and patients’ preferences were recorded. Two independent rheumatologists evaluated the data to assess the implementation of T2T concept. Statistical analysis: The associations between T2T concept implementation and categorical and continuous variables were assessed by Chi square test, t-test or Mann-Whitney test as appropriate. ANOVA or Kruskal-Wallis test was used to compare continuous variables between centers as appropriate.
Results: The seven participating centers reported 724 patients; age 62.6±13.97 years, 575 (80.4%) of them women. According to the reported data, 353 (65.4%) never smoked, 474 (73.3%) were married, 592 (86.8%) lived in cities, 191 (45.7%) had above high school education, 524 (72.4%) had comorbidities, 399 (66.4%) were RF positive and 125 (59.8%) had erosions. Four centers used more than one scoring method, DAS-28 and CDAI being the most popular. Only 276 (38.1%) of the patients had disease score results in ≥3 visits. The T2T approach was implemented in 245 (33.8%) of the 724 patients. The rate of implementation varied between centers (11.1%-87% p<0.0001), and was higher in younger patients (p=0.028), non-Jews (p=0.048), alcohol consuming (p=0.009) and RF positive patients (p=0.011). There was no correlation between the T2T implementation and gender, place of residence, education, smoking, treatment regimens, and the presence of erosions or comorbidities.
Conclusion: In our sample, the implementation of the T2T concept was limited. Further studies are needed to determine the reasons for this deviation from this desirable standard as well as its consequences.
To cite this abstract in AMA style:Zisman D, Oren S, Reitblat T, Lidar M, Balbir-Gurman A, Rosner IA, Feld J, Halabi N, Kassem S, Elkayam O. Implementation of the Treat to Target Concept in Evaluation of Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/implementation-of-the-treat-to-target-concept-in-evaluation-of-rheumatoid-arthritis-patients/. Accessed December 5, 2020.
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