Treat-to-Target Interventions for RA Do Not Increase Adverse Events, Resource Use

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Rheumatology visits, use of laboratory monitoring, and diagnostic imaging did not increase during treat-to-target interventions in rheumatoid arthritis.
Rheumatology visits, use of laboratory monitoring, and diagnostic imaging did not increase during treat-to-target interventions in rheumatoid arthritis.

Rheumatology visits, use of laboratory monitoring, and diagnostic imaging do not increase during treat-to-target interventions for patients with rheumatoid arthritis (RA), according to results published in Arthritis Research & Care.

In addition, the results indicated that the risk for adverse events did not increase during treat-to-target interventions.

The study included participants with RA from 6 practices enrolled in an 18-month cluster-randomized controlled trial. The researchers compared adverse events and resource use before (months 1-9) and during (months 10-18) a treat-to-target intervention. The researchers used medical records to determine adverse events and resource use.

Overall, the researchers examined records of 321 participants before the intervention and 315 during the intervention.

Before the intervention, 10.2% of visits included a report of an adverse event compared with 8.8% during the intervention (P =.41).

Before the intervention, 53.6% of participants used biologic disease-modifying antirheumatic drugs compared with 49.8% during the intervention (P =.73).

Rheumatology visits were more frequent before the intervention (mean, 4.0±1.4) compared with during the intervention (mean, 3.6±1.2; P =.02). In addition, there were more monitoring laboratory tests before (90.0%) compared with during (52.7%) the intervention (P <.001). Before the intervention, more visits included diagnostic testing (15.4%) compared with during the intervention (8.9%; P <.001).

"Prior work demonstrates the clinical benefits of [treat to target], which may translate into a reduction in resource use," the researchers wrote. "But, most importantly, patients treated with a [treat to target] approach do not appear to be at risk of increased adverse events."

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Reference

Solomon DH, Yu Z, Katz JN, et al. Adverse events and resource use before and after treat to target in rheumatoid arthritis: a post-hoc analysis of a randomized controlled trial [published online September 17, 2018]. Arthritis Care Res. doi: 10.1002/acr.23755

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