RA outcomes improve with close monitoring

Outcomes in patients with rheumatoid arthritis (RA) are improved with systematic monitoring of disease activity in daily practice. Needed are a tight control strategy aimed for at least low disease activity and frequent follow-up.

Katchamart and Bombardier extrapolated data from 3 International 3e Initiative studies, Tight Control for Rheumatoid Arthritis (TICORA), Fransen, and Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA). Each study compared intensive treatment and standardized monitoring with “usual care.”

All studies showed that close follow-up improves remission rates. In the TICORA trial, the triad of Disease Activity Score monitoring aimed at least low disease activity, monthly follow-up, and aggressive use of disease-modifying antirheumatic drugs (DMARDs) achieved a remission rate of 65%, compared with 16% in the usual-care group. In the Fransen study, targeted treatment aimed at low disease activity prompted more changes in DMARD regimen, causing 31% of patients to have reduced RA activity, versus 16% in usual care. In the CAMERA study, 50% of patients monitored with monthly follow-up and a computer decision program experienced remission, versus 37% of the usual-care group.

The authors noted that which parameters should be recommended for assessing a clinically meaningful response in daily practice is an important question.