The clinical effectiveness and cost-effectiveness of treat-to-target strategies in rheumatoid arthritis: a systematic review and cost-effectiveness analysis

Wailoo A, Hock E S, Stevenson M, Martyn-St James M, Rawdin A, Simpson E, Wong R, Dracup N, Scott D L & Young A.
Record ID 32015000625
English
Authors' objectives: To investigate the clinical effectiveness and cost-effectiveness of Treat to target (TTT) compared with routine care. TTT is a broad concept for treating patients with rheumatoid arthritis (RA). It involves setting a treatment target, usually remission or low disease activity (LDA). This is often combined with frequent patient assessment and intensive and rapidly adjusted drug treatment, sometimes based on a formal protocol.
Authors' recommendations: In early RA and studies of mixed early and established RA populations, evidence suggests that TTT improves remission rates. In established disease, TTT may lead to improved rates of LDA. It remains unclear which element(s) of TTT (the target, treatment protocols or increased frequency of patient visits) drive these outcomes. Future trials comparing TTT with usual care and/or different TTT targets should use outcomes comparable with existing literature. Remission, defined in a consistent manner, should be the target of choice of future studies.
Details
Project Status: Completed
Year Published: 2017
URL for published report: https://www.journalslibrary.nihr.ac.uk/hta/hta21710/#/abstract
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Adult
  • Attitude of Health Personnel
  • Drug Utilization Review
  • Education, Medical, Continuing
  • Female
  • Italy
  • Male
  • Middle Aged
  • Program Evaluation
  • Surveys and Questionnaires
  • Antirheumatic Agents
  • Arthritis, Rheumatoid
  • Guideline Adherence
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Rheumatology
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.