Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update
Identifieur interne : 002E35 ( Main/Exploration ); précédent : 002E34; suivant : 002E36Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update
Auteurs : Michaela A. Stoffer [Autriche] ; Monika M. Schoels [Autriche] ; Josef S. Smolen [Autriche] ; Daniel Aletaha [Autriche] ; Ferdinand C. Breedveld [Pays-Bas] ; Gerd Burmester [Allemagne] ; Vivian Bykerk [États-Unis] ; Maxime Dougados [France] ; Paul Emery [Royaume-Uni] ; Boulos Haraoui [Canada] ; Juan Gomez-Reino [Espagne] ; Tore K. Kvien [Norvège] ; Peter Nash [Australie] ; Victoria Navarro-Compán [Pays-Bas, Espagne] ; Marieke Scholte-Voshaar [Pays-Bas] ; Ronald Van Vollenhoven [Suède] ; Désirée Van Der Heijde [Pays-Bas] ; Tanja A. Stamm [Autriche]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2015.
Descripteurs français
- KwdFr :
- Antirhumatismaux (usage thérapeutique), Comorbidité, Essais cliniques comme sujet, Humains, Indice de gravité médicale, Médecine factuelle, Planification des soins du patient, Polyarthrite rhumatoïde (imagerie diagnostique), Polyarthrite rhumatoïde (physiopathologie), Polyarthrite rhumatoïde (traitement médicamenteux), Radiographie, Résultat thérapeutique.
- MESH :
- imagerie diagnostique : Polyarthrite rhumatoïde.
- physiopathologie : Polyarthrite rhumatoïde.
- traitement médicamenteux : Polyarthrite rhumatoïde.
- usage thérapeutique : Antirhumatismaux.
- Comorbidité, Essais cliniques comme sujet, Humains, Indice de gravité médicale, Médecine factuelle, Planification des soins du patient, Radiographie, Résultat thérapeutique.
English descriptors
- KwdEn :
- Antirheumatic Agents (therapeutic use), Arthritis, Rheumatoid (diagnostic imaging), Arthritis, Rheumatoid (drug therapy), Arthritis, Rheumatoid (physiopathology), Clinical Trials as Topic, Comorbidity, Evidence-Based Medicine, Humans, Patient Care Planning, Radiography, Severity of Illness Index, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Antirheumatic Agents.
- diagnostic imaging : Arthritis, Rheumatoid.
- drug therapy : Arthritis, Rheumatoid.
- physiopathology : Arthritis, Rheumatoid.
- Clinical Trials as Topic, Comorbidity, Evidence-Based Medicine, Humans, Patient Care Planning, Radiography, Severity of Illness Index, Treatment Outcome.
Abstract
A systematic literature review (SLR; 2009–2014) to compare a target-oriented approach with routine management in the treatment of rheumatoid arthritis (RA) to allow an update of the treat-to-target recommendations.
Two SLRs focused on clinical trials employing a treatment approach targeting a specific clinical outcome were performed. In addition to testing clinical, functional and/or structural changes as endpoints, comorbidities, cardiovascular risk, work productivity and education as well as patient self-assessment were investigated. The searches covered MEDLINE, EMBASE, Cochrane databases and Clinicaltrial.gov for the period between 2009 and 2012 and separately for the period of 2012 to May of 2014.
Of 8442 citations retrieved in the two SLRs, 176 articles underwent full-text review. According to predefined inclusion/exclusion criteria, six articles were included of which five showed superiority of a targeted treatment approach aiming at least at low-disease activity versus routine care; in addition, publications providing supportive evidence were also incorporated that aside from expanding the evidence provided by the above six publications allowed concluding that a target-oriented approach leads to less comorbidities and cardiovascular risk and better work productivity than conventional care.
The current study expands the evidence that targeting low-disease activity or remission in the management of RA conveys better outcomes than routine care.
Url:
DOI: 10.1136/annrheumdis-2015-207526
PubMed: 25990290
PubMed Central: 4717391
Affiliations:
- Allemagne, Australie, Autriche, Canada, Espagne, France, Norvège, Pays-Bas, Royaume-Uni, Suède, États-Unis
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Le document en format XML
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Breedveld</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Burmester, Gerd" sort="Burmester, Gerd" uniqKey="Burmester G" first="Gerd" last="Burmester">Gerd Burmester</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Department of Rheumatology and Clinical Immunology</addr-line>,<institution>Charité—University Medicine Berlin, Free University and Humboldt University Berlin</institution>,<addr-line>Berlin</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bykerk, Vivian" sort="Bykerk, Vivian" uniqKey="Bykerk V" first="Vivian" last="Bykerk">Vivian Bykerk</name><affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Division of Rheumatology</addr-line>,<institution>Weill Cornell Medical College, Cornell University, Hospital for Special Surgery</institution>,<addr-line>New York</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Rheumatology,</addr-line><institution>Hôpital Cochin, Paris Descartes University, Assistance Publique—Hôpitaux de Paris; INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name><affiliation wicri:level="1"><nlm:aff id="af8"><addr-line>Academic Unit of Musculoskeletal Disease</addr-line>,<institution>University of Leeds</institution>,<addr-line>Leeds</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name><affiliation wicri:level="1"><nlm:aff id="af9"><addr-line>Rheumatic Disease Unit</addr-line>,<institution>University of Montreal</institution>,<addr-line>Montreal</addr-line>,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Gomez Reino, Juan" sort="Gomez Reino, Juan" uniqKey="Gomez Reino J" first="Juan" last="Gomez-Reino">Juan Gomez-Reino</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Rheumatology Service and Department of Medicine</addr-line>,<institution>Hospital Clinico Universitario, Universidad de Santiago</institution>,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kvien, Tore K" sort="Kvien, Tore K" uniqKey="Kvien T" first="Tore K" last="Kvien">Tore K. Kvien</name><affiliation wicri:level="1"><nlm:aff id="af11"><addr-line>Department of Rheumatology</addr-line>,<institution>Diakonhjemmet Hospital</institution>,<addr-line>Oslo</addr-line>,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Nash, Peter" sort="Nash, Peter" uniqKey="Nash P" first="Peter" last="Nash">Peter Nash</name><affiliation wicri:level="1"><nlm:aff id="af12"><addr-line>Department of Medicine</addr-line>,<institution>University of Queensland</institution>,<addr-line>Brisbane</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Navarro Compan, Victoria" sort="Navarro Compan, Victoria" uniqKey="Navarro Compan V" first="Victoria" last="Navarro-Compán">Victoria Navarro-Compán</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Department of Rheumatology</addr-line>,<institution>University Hospital La Paz</institution>,<addr-line>Madrid</addr-line>,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Scholte Voshaar, Marieke" sort="Scholte Voshaar, Marieke" uniqKey="Scholte Voshaar M" first="Marieke" last="Scholte-Voshaar">Marieke Scholte-Voshaar</name><affiliation wicri:level="1"><nlm:aff id="af14"><addr-line>Department of Psychology</addr-line>,<institution>Health and Technology, University of Twente</institution>,<addr-line>Enschede</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Vollenhoven, Ronald" sort="Van Vollenhoven, Ronald" uniqKey="Van Vollenhoven R" first="Ronald" last="Van Vollenhoven">Ronald Van Vollenhoven</name><affiliation wicri:level="1"><nlm:aff id="af15"><institution>The Karolinska Institute</institution>,<addr-line>Stockholm</addr-line>,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Stamm, Tanja A" sort="Stamm, Tanja A" uniqKey="Stamm T" first="Tanja A" last="Stamm">Tanja A. 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Stoffer</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Division of Rheumatology, Department of Medicine 3</addr-line>,<institution>Medical University of Vienna</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><institution>University of Applied Sciences for Health Professions Upper Austria</institution>,<addr-line>Linz</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Schoels, Monika M" sort="Schoels, Monika M" uniqKey="Schoels M" first="Monika M" last="Schoels">Monika M. Schoels</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Internal Medicine</addr-line>,<institution>Centre for Rheumatic Diseases</institution>,<institution>Hietzing Hospital</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Division of Rheumatology, Department of Medicine 3</addr-line>,<institution>Medical University of Vienna</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Internal Medicine</addr-line>,<institution>Centre for Rheumatic Diseases</institution>,<institution>Hietzing Hospital</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Division of Rheumatology, Department of Medicine 3</addr-line>,<institution>Medical University of Vienna</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Breedveld, Ferdinand C" sort="Breedveld, Ferdinand C" uniqKey="Breedveld F" first="Ferdinand C" last="Breedveld">Ferdinand C. Breedveld</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Burmester, Gerd" sort="Burmester, Gerd" uniqKey="Burmester G" first="Gerd" last="Burmester">Gerd Burmester</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Department of Rheumatology and Clinical Immunology</addr-line>,<institution>Charité—University Medicine Berlin, Free University and Humboldt University Berlin</institution>,<addr-line>Berlin</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bykerk, Vivian" sort="Bykerk, Vivian" uniqKey="Bykerk V" first="Vivian" last="Bykerk">Vivian Bykerk</name><affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Division of Rheumatology</addr-line>,<institution>Weill Cornell Medical College, Cornell University, Hospital for Special Surgery</institution>,<addr-line>New York</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Rheumatology,</addr-line><institution>Hôpital Cochin, Paris Descartes University, Assistance Publique—Hôpitaux de Paris; INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name><affiliation wicri:level="1"><nlm:aff id="af8"><addr-line>Academic Unit of Musculoskeletal Disease</addr-line>,<institution>University of Leeds</institution>,<addr-line>Leeds</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name><affiliation wicri:level="1"><nlm:aff id="af9"><addr-line>Rheumatic Disease Unit</addr-line>,<institution>University of Montreal</institution>,<addr-line>Montreal</addr-line>,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Gomez Reino, Juan" sort="Gomez Reino, Juan" uniqKey="Gomez Reino J" first="Juan" last="Gomez-Reino">Juan Gomez-Reino</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Rheumatology Service and Department of Medicine</addr-line>,<institution>Hospital Clinico Universitario, Universidad de Santiago</institution>,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kvien, Tore K" sort="Kvien, Tore K" uniqKey="Kvien T" first="Tore K" last="Kvien">Tore K. Kvien</name><affiliation wicri:level="1"><nlm:aff id="af11"><addr-line>Department of Rheumatology</addr-line>,<institution>Diakonhjemmet Hospital</institution>,<addr-line>Oslo</addr-line>,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Nash, Peter" sort="Nash, Peter" uniqKey="Nash P" first="Peter" last="Nash">Peter Nash</name><affiliation wicri:level="1"><nlm:aff id="af12"><addr-line>Department of Medicine</addr-line>,<institution>University of Queensland</institution>,<addr-line>Brisbane</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Navarro Compan, Victoria" sort="Navarro Compan, Victoria" uniqKey="Navarro Compan V" first="Victoria" last="Navarro-Compán">Victoria Navarro-Compán</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Department of Rheumatology</addr-line>,<institution>University Hospital La Paz</institution>,<addr-line>Madrid</addr-line>,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Scholte Voshaar, Marieke" sort="Scholte Voshaar, Marieke" uniqKey="Scholte Voshaar M" first="Marieke" last="Scholte-Voshaar">Marieke Scholte-Voshaar</name><affiliation wicri:level="1"><nlm:aff id="af14"><addr-line>Department of Psychology</addr-line>,<institution>Health and Technology, University of Twente</institution>,<addr-line>Enschede</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Vollenhoven, Ronald" sort="Van Vollenhoven, Ronald" uniqKey="Van Vollenhoven R" first="Ronald" last="Van Vollenhoven">Ronald Van Vollenhoven</name><affiliation wicri:level="1"><nlm:aff id="af15"><institution>The Karolinska Institute</institution>,<addr-line>Stockholm</addr-line>,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Rheumatology</addr-line>,<institution>Leiden University Medical Center</institution>,<addr-line>Leiden</addr-line>,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Stamm, Tanja A" sort="Stamm, Tanja A" uniqKey="Stamm T" first="Tanja A" last="Stamm">Tanja A. Stamm</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Division of Rheumatology, Department of Medicine 3</addr-line>,<institution>Medical University of Vienna</institution>,<addr-line>Vienna</addr-line>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Annals of the Rheumatic Diseases</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antirheumatic Agents (therapeutic use)</term><term>Arthritis, Rheumatoid (diagnostic imaging)</term><term>Arthritis, Rheumatoid (drug therapy)</term><term>Arthritis, Rheumatoid (physiopathology)</term><term>Clinical Trials as Topic</term><term>Comorbidity</term><term>Evidence-Based Medicine</term><term>Humans</term><term>Patient Care Planning</term><term>Radiography</term><term>Severity of Illness Index</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antirhumatismaux (usage thérapeutique)</term><term>Comorbidité</term><term>Essais cliniques comme sujet</term><term>Humains</term><term>Indice de gravité médicale</term><term>Médecine factuelle</term><term>Planification des soins du patient</term><term>Polyarthrite rhumatoïde (imagerie diagnostique)</term><term>Polyarthrite rhumatoïde (physiopathologie)</term><term>Polyarthrite rhumatoïde (traitement médicamenteux)</term><term>Radiographie</term><term>Résultat thérapeutique</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antirheumatic Agents</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Arthritis, Rheumatoid</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Arthritis, Rheumatoid</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Polyarthrite rhumatoïde</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Polyarthrite rhumatoïde</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arthritis, Rheumatoid</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Polyarthrite rhumatoïde</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antirhumatismaux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Trials as Topic</term><term>Comorbidity</term><term>Evidence-Based Medicine</term><term>Humans</term><term>Patient Care Planning</term><term>Radiography</term><term>Severity of Illness Index</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Comorbidité</term><term>Essais cliniques comme sujet</term><term>Humains</term><term>Indice de gravité médicale</term><term>Médecine factuelle</term><term>Planification des soins du patient</term><term>Radiographie</term><term>Résultat thérapeutique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>A systematic literature review (SLR; 2009–2014) to compare a target-oriented approach with routine management in the treatment of rheumatoid arthritis (RA) to allow an update of the treat-to-target recommendations.</p></sec><sec><title>Methods</title><p>Two SLRs focused on clinical trials employing a treatment approach targeting a specific clinical outcome were performed. In addition to testing clinical, functional and/or structural changes as endpoints, comorbidities, cardiovascular risk, work productivity and education as well as patient self-assessment were investigated. The searches covered MEDLINE, EMBASE, Cochrane databases and Clinicaltrial.gov for the period between 2009 and 2012 and separately for the period of 2012 to May of 2014.</p></sec><sec><title>Results</title><p>Of 8442 citations retrieved in the two SLRs, 176 articles underwent full-text review. According to predefined inclusion/exclusion criteria, six articles were included of which five showed superiority of a targeted treatment approach aiming at least at low-disease activity versus routine care; in addition, publications providing supportive evidence were also incorporated that aside from expanding the evidence provided by the above six publications allowed concluding that a target-oriented approach leads to less comorbidities and cardiovascular risk and better work productivity than conventional care.</p></sec><sec><title>Conclusions</title><p>The current study expands the evidence that targeting low-disease activity or remission in the management of RA conveys better outcomes than routine care.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Van Der Heijde, Dm" uniqKey="Van Der Heijde D">DM van der Heijde</name></author><author><name sortKey="Van Hof, M" uniqKey="Van Hof M">M van ‘t 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sortKey="Dale, J Sa" uniqKey="Dale J">J SA Dale</name></author><author><name sortKey="Mcinnes, Ib" uniqKey="Mcinnes I">IB McInnes</name></author><author><name sortKey="Porter, D" uniqKey="Porter D">D Porter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dale, J" uniqKey="Dale J">J Dale</name></author><author><name sortKey="Purves, D" uniqKey="Purves D">D Purves</name></author><author><name sortKey="Mcconnachie, A" uniqKey="Mcconnachie A">A McConnachie</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Canada</li><li>Espagne</li><li>France</li><li>Norvège</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country></list><tree><country name="Autriche"><noRegion><name sortKey="Stoffer, Michaela A" sort="Stoffer, Michaela A" uniqKey="Stoffer M" first="Michaela A" last="Stoffer">Michaela A. Stoffer</name></noRegion><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name><name sortKey="Schoels, Monika M" sort="Schoels, Monika M" uniqKey="Schoels M" first="Monika M" last="Schoels">Monika M. Schoels</name><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name><name sortKey="Stamm, Tanja A" sort="Stamm, Tanja A" uniqKey="Stamm T" first="Tanja A" last="Stamm">Tanja A. Stamm</name><name sortKey="Stoffer, Michaela A" sort="Stoffer, Michaela A" uniqKey="Stoffer M" first="Michaela A" last="Stoffer">Michaela A. Stoffer</name></country><country name="Pays-Bas"><noRegion><name sortKey="Breedveld, Ferdinand C" sort="Breedveld, Ferdinand C" uniqKey="Breedveld F" first="Ferdinand C" last="Breedveld">Ferdinand C. Breedveld</name></noRegion><name sortKey="Navarro Compan, Victoria" sort="Navarro Compan, Victoria" uniqKey="Navarro Compan V" first="Victoria" last="Navarro-Compán">Victoria Navarro-Compán</name><name sortKey="Scholte Voshaar, Marieke" sort="Scholte Voshaar, Marieke" uniqKey="Scholte Voshaar M" first="Marieke" last="Scholte-Voshaar">Marieke Scholte-Voshaar</name><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name></country><country name="Allemagne"><noRegion><name sortKey="Burmester, Gerd" sort="Burmester, Gerd" uniqKey="Burmester G" first="Gerd" last="Burmester">Gerd Burmester</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Bykerk, Vivian" sort="Bykerk, Vivian" uniqKey="Bykerk V" first="Vivian" last="Bykerk">Vivian Bykerk</name></noRegion></country><country name="France"><noRegion><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name></noRegion></country><country name="Espagne"><noRegion><name sortKey="Gomez Reino, Juan" sort="Gomez Reino, Juan" uniqKey="Gomez Reino J" first="Juan" last="Gomez-Reino">Juan Gomez-Reino</name></noRegion><name sortKey="Navarro Compan, Victoria" sort="Navarro Compan, Victoria" uniqKey="Navarro Compan V" first="Victoria" last="Navarro-Compán">Victoria Navarro-Compán</name></country><country name="Norvège"><noRegion><name sortKey="Kvien, Tore K" sort="Kvien, Tore K" uniqKey="Kvien T" first="Tore K" last="Kvien">Tore K. Kvien</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Nash, Peter" sort="Nash, Peter" uniqKey="Nash P" first="Peter" last="Nash">Peter Nash</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Van Vollenhoven, Ronald" sort="Van Vollenhoven, Ronald" uniqKey="Van Vollenhoven R" first="Ronald" last="Van Vollenhoven">Ronald Van Vollenhoven</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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