RT Journal Article
SR Electronic
T1 Evidence for treating rheumatoid arthritis to target: results of a systematic literature search
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 638
OP 643
DO 10.1136/ard.2009.123976
VO 69
IS 4
A1 Schoels, Monika
A1 Knevel, Rachel
A1 Aletaha, Daniel
A1 Bijlsma, Johannes W J
A1 Breedveld, Ferdinand C
A1 Boumpas, Dimitrios T
A1 Burmester, Gerd
A1 Combe, Bernard
A1 Cutolo, Maurizio
A1 Dougados, Maxime
A1 Emery, Paul
A1 van der Heijde, Desirée
A1 Huizinga, Tom W J
A1 Kalden, Joachim
A1 Keystone, Edward C
A1 Kvien, Tore K
A1 Martin-Mola, Emilio
A1 Montecucco, Carlomaurizio
A1 de Wit, Maarten
A1 Smolen, Josef S
YR 2010
UL http://ard.bmj.com/content/69/4/638.abstract
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.