Long-term outcome of a treat-to-target strategy in late-onset rheumatoid arthritis with chronic lung disease: 5-year results of a prospective observational study

Nomura, M; Sugihara, T; Baba, H; Hosoya, T; Kamiya, M; Ishizaki, T; Matsumoto, T; Kubo, K; Hirano, F; Kojima, M; Miyasaka, N; Yasuda, S; Harigai, M

doi:10.1186/s13075-025-03491-1

Rheumatoid arthritis

Long-term outcome of a treat-to-target strategy in late-onset rheumatoid arthritis with chronic lung disease: 5-year results of a prospective observational study

Arthritis Res TherPublished 3 Feb 2025Prospective observational study

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Authors' conclusion

For LORA patients with CLD, the T2T strategy is effective, but comorbidities and SAEs make the implementation of the T2T more difficult.

Study context

Population: Methotrexate (MTX)-naïve patients with late-onset RA (mean age 74.4 years) from a prospective, monocentric registryMTX-naïve late-onset rheumatoid arthritis (LORA)
Participants: 197 patients

Exposure: LORA with chronic lung disease (CLD) vs without CLD, under treat-to-target (T2T) strategy targeting low disease activity (LDA)
CLDn = 47
Outcome: Simplified disease activity index (SDAI) remission and Health Assessment Questionnaire Disability Index (HAQ-DI) ≤ 0.5 by non-responder imputation analysis
Follow-up: 5 years

Methodological detailsmonocentric registry, treat-to-target strategy, non-responder imputation

Monocentric registry
Treat-to-target strategy
Non-responder imputation

Main finding

As reported in the abstract

SDAI remission · year 5

CLD29.8%

Without CLD44.0%

P = 0.555

Observational data: associations, not effects.

Secondary outcomes

Co-primary: HAQ-DI ≤ 0.5 · year 5 · non-responder imputation

P = 0.939

CLD36.2%

Without CLD45.3%

Non-adherence to T2T due to comorbidities or adverse events

P = 0.027

CLD34.0%

Without CLD18.7%

Outcome	CLD	Without CLD
Tacrolimus initiated	25.5%	— not stated in the abstract

— not stated in the abstract

Safety

Outcome	← Lower risk with CLD ←→ Higher risk with CLD →	aHR (95% CI)	P value
SAEs: infections requiring hospitalisation, deterioration of extra-articular manifestations and fracturesMultivariable analysis	0.20.5125	2.53 (1.60–4.00)	P < 0.001
	0.20.5125Adjusted hazard ratio (log scale)

Original publication

Long-term outcome of a treat-to-target strategy in late-onset rheumatoid arthritis with chronic lung disease: 5-year results of a prospective observational study. Arthritis Res Ther. Published 3 February 2025. doi:10.1186/s13075-025-03491-1

Read the original article ↗

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