Furthermore, achieving remission and maintaining it over time remain challenging.2,3
Even for patients with moderate to high disease activity, there are obstacles to the T2T approach of switching DMARDs, including irreversible joint damage, patient concerns of potential side effects, and comorbidities.4
Only 11% of patients with recent-onset RA treated with csDMARDs achieved sustained remission at all follow-ups (Year 3, Year 4, and Year 5)2
As few as 32% of patients with RA achieve remission after 12 months of treatment, and only 64% after 24 months3
- non-TNFi or JAKi = 79%
- csDMARD = 70%
- TNFi = 68%
- Reduced clinical effectiveness
- Increased morbidity and mortality
- Increased healthcare utilisation (including longer hospital stays)
- Atherogenesis, MI, heart failure
- CVA
- Low stress tolerance
- Low bone mineral density
- Insulin resistance
- Malignancies (lymphoma, lung cancer)
Check out a summary of key clinical outcome measures
Explore and learn more about the pathogenesis of RA
AE, adverse event; bDMARD, biologic disease-modifying antirheumatic drug; CHD, coronary heart disease; CRP, C-reactive protein; csDMARD, conventional synthetic disease-modifying antirheumatic drug; CVA, cerebrovascular accident; CVD, cardiovascular disease; DAS, Disease Activity Score; DMARD, disease-modifying antirheumatic drug; HAQ, Health Assessment Questionnaire; HRQoL, health-related quality of life; HZ, herpes zoster; JAKi, Janus kinase inhibitor; MI, myocardial infarction; MOA, mechanism of action; PRO, patient-reported outcome; QoL, quality of life; RA, rheumatoid arthritis; SF-36, 36-item Short-Form Health Survey; T2T, treat to target; TJC28, Tender Joint Count Over 28 Joints; TNFi, tumour necrosis factor inhibitor; TNFα, tumour necrosis factor alpha; VAS, visual analogue scale; VTE, venous thromboembolism.
* Similar results among combination therapies.
REFERENCES
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