What is the best target in a treat-to-target strategy in rheumatoid arthritis? Results from a systematic review and meta-regression analysis
Authors' conclusion
Targeting SDAI/CDAI-LDA, and to a lesser extent DAS-remission, may be superior to targeting DAS-LDA regarding several clinical outcomes.
Study context
- Population
- Rheumatoid arthritis (RA) patients treated with a treat-to-target (T2T) strategy for ≥12 months115 treatment arms
- Comparison
- Different T2T targets: SDAI/CDAI-LDA vs DAS-LDA vs DAS-remission
- Outcome
- Clinical and radiographic outcomes by target used
Methodological detailsRCTs and cohort studies after 2003, T2T for ≥12 months, risk of bias by Cochrane Collaboration tool, correction for heterogeneity between and within studies
- RCTs and cohort studies after 2003
- T2T for ≥12 months
- Risk of bias by Cochrane Collaboration tool
- Correction for heterogeneity between and within studies
Pooled result
As reported in the abstract
1-3 years
- SDAI/CDAI-LDA statistically superior to DAS-LDA for DAS-remission and SDAI/CDAI/Boolean-remission over 1-3 years
- SDAI/CDAI-LDA significantly superior to DAS-remission for SDAI/CDAI/Boolean-remission (over 1-3 years) and mean SDAI/CDAI (over 1 year)
- DAS-remission vs DAS-LDA improved only % in DAS-remission, statistically significant only after 2-3 years of T2T
- No differences in HAQ and radiographic progression
Original publication
What is the best target in a treat-to-target strategy in rheumatoid arthritis? Results from a systematic review and meta-regression analysis. RMD Open. Published 28 April 2023. doi:10.
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