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Achieving remission in clinical practice: lessons from clinical trial data
Vivian P Bykerk1, Edward C Keystone, Bindee Kuriya
1Hospital for Special Surgery, New York City, USA. bykerkv@hss.edu
Clinical and Experimental Rheumatology
|April 30, 2013
Summary
Early rheumatoid arthritis (ERA) treatment with combination disease-modifying anti-rheumatic drugs (DMARDs) or biologics, and tight control strategies, effectively achieve remission. Achieving sustained remission improves radiographic and functional outcomes in ERA patients.
Area of Science:
- Rheumatology
- Clinical Medicine
- Pharmacology
Background:
- Early rheumatoid arthritis (ERA) requires effective treatment strategies to achieve remission and prevent long-term joint damage.
- Remission rates vary significantly based on treatment modalities and adherence to remission criteria.
- Understanding optimal treatment approaches is crucial for improving patient outcomes in ERA.
Purpose of the Study:
- To review the literature on remission rates in early rheumatoid arthritis (ERA) across various treatment strategies.
- To evaluate the effectiveness of different treatment approaches in achieving remission and radiographic non-progression.
- To discuss practical considerations for achieving and maintaining remission in ERA.
Main Methods:
- Systematic literature search of CINAHL, EMBASE, and Medline (PubMed) databases (2000-2012).
- Inclusion of trials reporting remission and/or radiographic non-progression outcomes.
- Extraction and examination of data based on unified remission criteria.
Main Results:
- Early treatment with disease-modifying anti-rheumatic drug (DMARD) combination therapy demonstrates significant benefits.
- Combination therapy including biologics and tight control with pre-specified targets are effective in achieving remission.
- The 2011 remission criteria may enhance the identification of true remission, and predictors of sustained remission are important for outcomes.
Conclusions:
- Early and aggressive treatment strategies, including DMARD combinations and biologics, are key to achieving remission in ERA.
- Tight control and adherence to updated remission criteria can improve patient prognosis.
- Identifying predictors for sustained remission is vital for optimizing long-term radiographic and functional outcomes in early rheumatoid arthritis.
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