PT  - JOURNAL ARTICLE
AU  - Schoels, Monika
AU  - Knevel, Rachel
AU  - Aletaha, Daniel
AU  - Bijlsma, Johannes W J
AU  - Breedveld, Ferdinand C
AU  - Boumpas, Dimitrios T
AU  - Burmester, Gerd
AU  - Combe, Bernard
AU  - Cutolo, Maurizio
AU  - Dougados, Maxime
AU  - Emery, Paul
AU  - van der Heijde, Desirée
AU  - Huizinga, Tom W J
AU  - Kalden, Joachim
AU  - Keystone, Edward C
AU  - Kvien, Tore K
AU  - Martin-Mola, Emilio
AU  - Montecucco, Carlomaurizio
AU  - de Wit, Maarten
AU  - Smolen, Josef S
TI  - Evidence for treating rheumatoid arthritis to target: results of a systematic literature search
AID  - 10.1136/ard.2009.123976
DP  - 2010 Apr 01
TA  - Annals of the Rheumatic Diseases
PG  - 638--643
VI  - 69
IP  - 4
4099  - http://ard.bmj.com/content/69/4/638.short
4100  - http://ard.bmj.com/content/69/4/638.full
SO  - Ann Rheum Dis2010 Apr 01; 69
AB  - Objectives To summarise existing evidence on a target oriented approach for rheumatoid arthritis (RA) treatment. Methods We conducted a systematic literature search including all clinical trials testing clinical, functional, or structural values of a targeted treatment approach. Our search covered Medline, Embase and Cochrane databases until December 2008 and also conference abstracts (2007, 2008). Results The primary search yielded 5881 citations; after the selection process, 76 papers underwent detailed review. Of these, only seven strategic clinical trials were extracted: four studies randomised patients to routine or targeted treatment, two compared two different randomised targets and one compared targeted treatment to a historical control group. Five trials dealt with early RA patients. All identified studies showed significantly better clinical outcomes of targeted approaches than routine approaches. Disability was reported in two studies with no difference between groups. Four studies compared radiographic outcomes, two showing significant benefit of the targeted approach. Conclusion Only few studies employed randomised controlled settings to test the value of treatment to a specific target. However, they provided unanimous evidence for benefits of targeted approaches. Nevertheless, more data on radiographic and functional outcomes and on patients with established RA are needed.