Treat-to-target strategies are feasible in elderly-onset rheumatoid arthritis given its reassuring risk–benefit profile
Authors' conclusion
A T2T approach is feasible and effective in EORA, given its reassuring risk-benefit profile, while recognising the need for individualised management.
Study context
- Population
- Patients with RA (1987/2010 criteria) in the treatment in the Rotterdam Early Arthritis cohort trial
- Participants
- 425 patients
- Comparison
- Elderly-onset RA vs young-onset RA under a treat-to-target (T2T) strategy
- Elderly-onset rheumatoid arthritis (EORA)n = 98
- Young-onset RA (YORA)n = 327reference
- Primary endpoint
- 2-year pharmacotherapy needs and AE profiles
- Follow-up
- 2 years
Methodological detailsmulticentre, treat-to-target, fixed medication protocol, mixed-effects models, Cox proportional hazards models
- Multicentre
- Treat-to-target
- Fixed medication protocol
- Mixed-effects models
- Cox proportional hazards models
Primary result
As reported in the abstract
DAS44 trajectories, active disease and sustained remission
Mean difference (DAS44 trajectories) (95% CI)
Between EORA and YORA
0.03(−0.13 to 0.18)
Estimate (95% CI)
EORAvs YORA
OR (active disease) 0.8(0.4–1.5)
EORAvs YORA
OR (sustained remission) 1.5(0.6–3.4)
Further findings
| Outcome | EORA | YORA | HR (95% CI) | |
|---|---|---|---|---|
| bDMARD initiationLower and slower in EORA | 28% | 38% | 0.7 (0.4–1) | |
| 0.512Hazard ratio (log scale) |
D2T-RA prevalence · rare
First bDMARD survival and glucocorticoid (GC) use
- Comparable between groups
Safety
Treatment adjustments due to AEs · similar
Original publication
Treat-to-target strategies are feasible in elderly-onset rheumatoid arthritis given its reassuring risk–benefit profile. RMD Open. Published 3 July 2026. doi:10.
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