• Jason Jungsik Song, Yeong Wook Song, Sang Cheol Bae, Hoon-Suk Cha, Jung-Yoon Choe, Sung Jae Choi, Hyun Ah Kim, Jinseok Kim, Sung-Soo Kim, Choong-Ki Lee, Jisoo Lee, Sang-Heon Lee, Shin-Seok Lee, Soo-Kon Lee, Sung Won Lee, Sung-Hwan Park, Won Park, Seung Cheol Shim, Chang-Hee Suh, Bin Yoo, Dae-Hyun Yoo, and Wan-Hee Yoo.
• Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2018 Dec 24; 33 (52): e346e346.

BackgroundTo evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea.MethodsIn a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) (2.6 ≤ DAS28 < 3.2).ResultsData were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001).ConclusionIn Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

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