Adherence to treat to target strategy in rheumatoid arthritis: Development of a tool for it assessment

Garcia Salinas Rodrigo*,Ruta Santiago, Salvatori Facundo, Ruta Alvaro,and Magri Sebastian

Introduction/Objective: The purpose of the treat to target (T2T) in Rheumatoid Arthritis (RA) is to achieve remission or Low Disease Activity (LDA) according to results from objective activity measurements. To assess the adherence of T2T and to evaluate the application of a tight control T2T-70 and T2T-100 tool, and its association with sustained low disease activity as a measure of outcome. Methods: Sustained LDA (sLDA) was defined when the patient had the Clinical Disease Activity Index (CDAI) lower than 10 during at least 6 months. Measures of adherence to T2T were defined as follows: T2T-70, when therapeutic decisions were accompanied by the measurement of activity by 70% and the interval between visits did not exceed 6 months; And T2T-100, when 100% of the decisions were accompanied with the activity measurement. Results: One hundred and two patients were included. A total of 526 visits were recorded. In 270 visit treatment adjustment was done and 208 (77%) of them were performed according to the CDAI. The frequency of LDAS was 20% (IC95: 12-30). The frequency of T2T-70 and 100 was 62.5% and 42% respectable; that compliance presented a statistically significant association to the achievement of sLDA (p<0.001). Compliance with T2T-70 was also associated with early diagnosis (p:0.009). Conclusion: A global adherence of T2T was 77%. This led to a sustained decrease in disease activity during follow-up. T2T-70 and 100 adherence tool were good, patients who met these criteria reached more sLDA.