Journal article
Assessing adequate treatment response in patients with rheumatoid arthritis
Clinical therapeutics, v 31(6), pp 1219-1231
2009
PMID: 19695389
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Rheumatoid arthritis (RA) presents a substantial socioeconomic burden that is potentially reduced by individualized, appropriate management strategies. Integral to such strategies is recognizing the need for treatment changes when patients inadequately respond or do not respond to treatment. However, there might be little or no agreement as to what constitutes treatment failure or an adequate response. Currently used American College of Rheumatology response criteria and the disease activity score may underestimate the magnitude of treatment failure when applied in clinical practice, and, having been designed to differentiate responses between large groups, they may be of limited value in monitoring individual patients.
Objective: The aim of this commentary was to assess how
treatment failure and
clinical remission/response have been defined in clinical studies.
Methods: A PubMed search (1948–2009) was conducted to identify clinical studies or reviews containing the following search terms:
rheumatoid arthritis and treatment failure, inadequate response, biologic therapy, DMARD, radiographic response, and
remission. Select clinical reports in patients with RA were included if remission or treatment failure, radiographic or other, was a study end point.
Results: Thirty–three studies were identified. The present assessment found no consensus as to what represents a practical definition of
treatment failure or
clinical remission in the clinical studies assessed. The definitions varied from the complete absence of any clinical disease to computer-generated numeric scales. The variability in clinical definitions of
treatment failure or
remission seems to have been mainly attributed to the time at which assessments were made, making it difficult to determine what
treatment failure or
remission means in individual patients with RA in clinical practice.
Conclusions: Based on the findings of the present commentary, standard definitions of
treatment failure or
clinical remission/response are needed. Aggressive treatment strategies with specific clinical goals may result in better long-term outcomes. Early evidence of treatment effect may serve to improve clinical outcomes, including remission, and help define and align treatment goals in patients with RA.
Metrics
Details
- Title
- Assessing adequate treatment response in patients with rheumatoid arthritis
- Creators
- Martin Jan Bergman - Drexel University
- Publication Details
- Clinical therapeutics, v 31(6), pp 1219-1231
- Publisher
- EM Inc USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Web of Science ID
- WOS:000268348500007
- Scopus ID
- 2-s2.0-68649121665
- Other Identifier
- 991019168498604721
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- Web of Science research areas
- Pharmacology & Pharmacy