Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update.
Ann Rheum Dis
; 75(1): 16-22, 2016 Jan.
Article
en En
| MEDLINE
| ID: mdl-25990290
ABSTRACT
OBJECTIVE:
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.METHODS:
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.RESULTS:
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.CONCLUSIONS:
The current study expands the evidence that targeting low-disease activity or remission in the management of RA conveys better outcomes than routine care.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Planificación de Atención al Paciente
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Artritis Reumatoide
/
Índice de Severidad de la Enfermedad
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Antirreumáticos
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Año:
2016
Tipo del documento:
Article