ArticleBMC musculoskeletal disorders2013
Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry.
Article in BMC musculoskeletal disorders, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update.Annals of the rheumatic diseases · 2016Pooled it
- Effectiveness of a treat-to-target strategy in patients with moderate to severely active rheumatoid arthritis treated with abatacept.Arthritis research & therapy · 2023Trial
- Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea.Journal of Korean medical science · 2018Trial
- Effectiveness of a telemonitoring intensive strategy in early rheumatoid arthritis: comparison with the conventional management approach.BMC musculoskeletal disorders · 2016Trial
- A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial.BMC musculoskeletal disorders · 2015Trial
- Treat-to-target in Behçet syndrome.Nature reviews. Rheumatology · 2026Review
- Adherence to Subcutaneous Anti-Tumour Necrosis Factor Treatment in a Cohort of Patients with Rheumatoid Arthritis Before and After the Implementation of a Comprehensive Care Model.Biologics : targets & therapy · 2022Article
- Validation of the Simplified Disease Activity Index (SDAI) with a quick quantitative C-reactive protein assay (SDAI-Q) in patients with rheumatoid arthritis: a prospective multicenter cross-sectional study.Therapeutic advances in musculoskeletal disease · 2022Article
- Value of Remission in Patients with Rheumatoid Arthritis: A Targeted Review.Advances in therapy · 2022Review
- Psoriasis treat to target: defining outcomes in psoriasis using data from a real-world, population-based cohort study (the British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR).The British journal of dermatology · 2020Article
- A Belgian consensus on the definition of a treat-to-target outcome set in psoriasis management.Journal of the European Academy of Dermatology and Venereology : JEADV · 2020Article
- Treat-To-Target and Treat-To-Budget in Rheumatoid Arthritis: Measuring the Value of Individual Therapeutic Interventions.Rheumatology and therapy · 2019Article
- Long-term clinical, functional, and cost outcomes for early rheumatoid arthritis patients who did or did not achieve early remission in a real-world treat-to-target strategy.Clinical rheumatology · 2019Article
- Novel Concepts in Psoriatic Arthritis Management: Can We Treat to Target?Current rheumatology reports · 2018Review
- Conceptual model for the health technology assessment of current and novel interventions in rheumatoid arthritis.PloS one · 2018Article
- Impact of ultrasonography on treatment decision in rheumatoid arthritis: the IMPULSAR study.Rheumatology international · 2017Article
- Cost-effectiveness of clinical remission by treat to target strategy in established rheumatoid arthritis: results of the CREATE registry.Rheumatology international · 2016Article
- Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System.Journal of comparative effectiveness research · 2016Article
- Validity of data collected in BIOREG, the Austrian register for biological treatment in rheumatology: current practice of bDMARD therapy in rheumatoid arthritis in Austria.BMC musculoskeletal disorders · 2016Article
- Remission-induction therapies for early rheumatoid arthritis: evidence to date and clinical implications.Therapeutic advances in musculoskeletal disease · 2016Review
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhere health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the cost-effectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA).
methodsWe used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) < 2.6). The UC cohort was treated without DAS28-guided treatment decisions. EuroQol-5D utility scores were estimated from the Health Assessment Questionnaire. A health care perspective was adopted and direct medical costs were collected. The incremental cost effectiveness ratio (ICER) per patient in remission and incremental cost utility ratio (ICUR) per quality-adjusted life year (QALY) gained were calculated over two and three years of follow-up.
resultsTwo year data were available for 261 T2T patients and 213 UC patients; an extended follow-up of three years was available for 127 and 180 patients, respectively. T2T produced higher remission percentages and a larger gain in QALYs than UC. The ICER was € 3,591 per patient in remission after two years and T2T was dominant after three years. The ICUR was € 19,410 per QALY after two years and T2T was dominant after three years.
conclusionsWe can conclude that treating to the target of remission in early RA is cost-effective compared with UC. The data suggest that in the third year, T2T becomes cost-saving.
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