Evidence map›Paper›PMID 25969430›Full record

ReviewAnnals of the rheumatic diseases2016

Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force.

Josef S Smolen, Ferdinand C Breedveld, Gerd R Burmester, Vivian Bykerk, Maxime Dougados, Paul Emery, Tore K Kvien, M Victoria Navarro-Compán, Susan Oliver, Monika Schoels and 33 more

3 registry-linked trialsAbstract readConsensus StatementReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Annals of the rheumatic diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 682 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
682citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT03228342 nacompletednot on this mapstarted 2017, after this paper: background citation

The Impact of Musculoskeletal Ultrasound-added to Clinical Evaluations- on Patient Reported Outcomes: A Prospective Study of Rheumatoid Arthritis Patients Classified in Remission/Low Disease Activity (ULTRAPRO)

TypeinterventionalSponsorClínica de Artritis TempranaRan2017 to 2019Enrolled94ConditionsRheumatoid Arthritis, Patient Reported Outcomes, Musculoskeletal UltrasoundArmsMusculoSkeletal Ultrasound
NCT04985435 phase4recruitingnot on this mapstarted 2021, after this paper: background citation

Better After CHoosing. Randomly Allocated or Patient Preference Based Treatment With Filgotinib or TNFi in Patients With Active Rheumatoid Arthritis (BACH)

TypeinterventionalSponsorR.BosRan2021 to 2025Enrolled100ConditionsRheumatoid ArthritisArmsFilgotinib, Anti-Tumor Necrosis Factor Alpha Drug (Product), 50 patients will have a Free Choice between Filgotinib and anti TNF
NCT05567380 unknown statusnot on this mapstarted 2022, after this paper: background citation

Comparative Study of JAK Inhibitors Vs TNF Inhibitors in Patients With Rheumatoid Arthritis

TypeobservationalSponsorSohag UniversityRan2022 to 2023Enrolled150ConditionsRheumatoid ArthritisArmsObservation
3 · Its place in the literature

Who cites it

682 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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622 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

43 authors.

Josef S SmolenDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria.
Ferdinand C BreedveldDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Gerd R BurmesterDepartment of Rheumatology, Clinical Immunology Free University and Humboldt University, Charité-University Medicine, Berlin, Germany.
Vivian BykerkDivision of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, USA.
Maxime DougadosDepartment of Rheumatology B, Cochin Hospital, René Descartes University, Paris, France.
Paul EmeryLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Tore K KvienDepartment of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
M Victoria Navarro-CompánDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Susan OliverSusan Oliver Associates, North Devon, UK.
Monika Schoels2nd Department of Medicine, Hietzing Hospital, Vienna, Austria.
Marieke Scholte-VoshaarEULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
Tanja StammDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
Michaela StofferDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
Tsutomu TakeuchiDivision of Rheumatology, Department of internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Daniel AletahaDivision of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
Jose Louis AndreuRheumatology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Spain.
Martin AringerDepartment of Medicine III, University Medical Center TU Dresden, Dresden, Germany.
Martin BergmanDrexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Neil BetteridgeEULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
Hans BijlsmaDepartment of Rheumatology and Clinical Immunology, University Medical Center Utrecht, and VU University Medical Center, Amsterdam, The Netherlands.
Harald BurkhardtDivision of Rheumatology, Department of Medicine, Johann-Wolfgang-Goethe University Frankfurt, German.
Mario CardielCentro de Investigación Clínica de Morelia, Morelia, Michoacán, Mexico.ORCID http://orcid.org/0000-0002-2731-9180
Bernard CombeService d'Immuno-Rhumatologie, Montpellier University, Lapeyronie Hospital, Montpellier, France.
Patrick DurezPôle de Recherche en Rhumatologie, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Joao Eurico FonsecaRheumatology Research Unit, Instituto de de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal Rheumatology Department, Lisbon Academic Medical Centre, Lisbon, Portugal.
Alan GibofskyWeill Medical College, Cornell University Hospital for Special Surgery, New York, USA.
Juan J Gomez-ReinoRheumatology Unit, Santiago University Clinical Hospital, Santiago de Compostela, Spain.
Winfried GraningerDivision of Rheumatology, Medical University of Graz, Graz, Austria.
Pekka HannonenDepartment of Medicine, Central Hospital, Jyväskylä, Finland.
Boulos HaraouiInstitut de Rhumatologie de Montréal, Quebec, Canada.
Marios KouloumasEULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
Robert LandeweAcademic Medical Center, University of Amsterdam, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
Emilio Martin-MolaUniversity Hospital La Paz, Madrid, Spain.
Peter NashUniversity of Queensland, Brisbane, Queensland, Australia.
Mikkel OstergaardDepartment of Clinical Medicine, Faculty of Health Sciences, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet and Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
Andrew ÖstörRheumatology Clinical Research Unit, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge University Hospitals, NHS Foundation Trust, Cambridge, UK.
Pam RichardsEULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
Tuulikki Sokka-IslerDepartment of Rheumatology, Central Hospital, Jyväskylä, Finland.
Carter ThorneDivision of Rheumatology, Southlake Regional Health Centre, Newarket, Ontario, Canada.
Athanasios G TzioufasDepartment of Pathophysiology, School of Medicine, University of Athens, Greece.
Ronald van VollenhovenRheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden.
Martinus de WitEULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
Desirée van der HeijdeDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID http://orcid.org/0000-0002-5781-158X

Funding

Arthritis Research UK 18475
6 · The paper itself

Abstract

backgroundReaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this therapeutic goal in routine clinical practice, but these recommendations need to be re-evaluated for appropriateness and practicability in the light of new insights.

objectiveTo update the 2010 treat-to-target recommendations based on systematic literature reviews (SLR) and expert opinion.

methodsA task force of rheumatologists, patients and a nurse specialist assessed the SLR results and evaluated the individual items of the 2010 recommendations accordingly, reformulating many of the items. These were subsequently discussed, amended and voted upon by >40 experts, including 5 patients, from various regions of the world. Levels of evidence, strengths of recommendations and levels of agreement were derived.

resultsThe update resulted in 4 overarching principles and 10 recommendations. The previous recommendations were partly adapted and their order changed as deemed appropriate in terms of importance in the view of the experts. The SLR had now provided also data for the effectiveness of targeting low-disease activity or remission in established rather than only early disease. The role of comorbidities, including their potential to preclude treatment intensification, was highlighted more strongly than before. The treatment aim was again defined as remission with low-disease activity being an alternative goal especially in patients with long-standing disease. Regular follow-up (every 1-3 months during active disease) with according therapeutic adaptations to reach the desired state was recommended. Follow-up examinations ought to employ composite measures of disease activity that include joint counts. Additional items provide further details for particular aspects of the disease, especially comorbidity and shared decision-making with the patient. Levels of evidence had increased for many items compared with the 2010 recommendations, and levels of agreement were very high for most of the individual recommendations (≥9/10).

conclusionsThe 4 overarching principles and 10 recommendations are based on stronger evidence than before and are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA.

Indexed as

Patient Care PlanningSeverity of Illness IndexAntirheumatic AgentsArthritis, RheumatoidComorbidityEvidence-Based MedicineHumansMaintenance ChemotherapyPatient ParticipationRemission InductionTerminology as TopicAntirheumatic AgentsDisease ActivityEarly Rheumatoid ArthritisOutcomes researchRheumatoid ArthritisTreatment

Identifiers

PMID25969430
PMCPMC4717393

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.