Efficacy and safety of treat-to-target strategy studies in rheumatic diseases: A systematic review and meta-analysis
Pooled result · Remission in RAResult — go to the resultPooled relative risk 1.68 CI 1.47–1.92Authors' conclusion
For patients with active RA, a T2T strategy has been shown in mulitple studies to increase the likelihood of achieving clinical response and improving HRQoL without increasing economic costs and AEs.
Study context
- Population
- Adults with inflammatory rheumatic diseases (rheumatoid arthritis (RA), psoriatic arthritis (PsA), spondyloarthritis (SpA), gout); PUBMED, EMBASE and CINAHL, January 1990 to December 202366 studies
- Comparison
- Treat-to-target (T2T) strategy vs usual care
- Outcome
- Remission in RA
- Follow-up
- 1 year
Methodological detailsrandom-effect meta-analysis, sensitivity analyses
- Random-effect meta-analysis
- Sensitivity analyses
Pooled result
As reported in the abstract
Pooled relative risk
1.68
CI 1.47–1.92
P < 0.001
T2Tvs UC
pooled RR 1.68 (CI 1.47–1.92); P < 0.001
- RA studies vs usual care (UC) showing significantly better clinical outcomes with T2T
- 83.3% (20/24)
Further pooled results
| Outcome | Pooled SMD (CI) | P value | |
|---|---|---|---|
| DAS-28 response in RA · 1 year | 0.47 (0.26–0.69) | P < 0.001 | |
| Mean change of HAQ score in RA | 1.48 (0.46–2.51) | P = 0.004 | |
| −2024Difference (linear scale) |
- Mean change of HAQ score in RA — Studies finding T2T significantly better for physical function and health-related quality of life (HRQoL)
- 11/19 (57.9%)
Radiographic progression in RA
- Studies showing greater benefit from T2T
- Five out of 9 studies (55.6%)
Cost-effectiveness in RA
- Studies finding T2T more cost-effective than UC
- 2/2
Safety
Adverse events (AEs) in RA
- Studies showing no tendency for AEs to occur more often with T2T
- 8/8
Original publication
Efficacy and safety of treat-to-target strategy studies in rheumatic diseases: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 21 May 2024. doi:10.
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