Comparison of initial versus delayed introduction of a treat-to-target strategy in patients with recent-onset rheumatoid arthritis: results of the T-4 3-year study.

We investigated whether a delayed treat-to-target strategy introduction was disadvantageous compared with the clinical, radiological, and functional efficacy of initial introduction on early rheumatoid arthritis (RA) after a 3-year follow-up (T-4 3-year) study. Between August 2008 and April 2010, 243 early RA patients (symptom duration <3 years) were randomly allocated to one of four strategy groups; we focus here on the routine care (R group) and the disease activity score in 28 joints (DAS28)1 plus matrix metalloproteinase (MMP)-3-driven therapy (T group)2 (figure 1).3 The T-4 3-year study followed a 1-year study. At 56 weeks, all subjects were allocated to the T group (R→T, RT group; T→T, TT group, etc.), and visits were every 4 weeks; the clinical variable assessment, each physician's articular examination and DAS28 calculations were every 12 weeks and at baseline. Figure 1 Subject disposition and study flow chart (A), tapering methods of biological agents (BA) (B) and percentage of subjects who met triple criteria for comprehensive disease remission over time (C–F) (non-responder imputation). (A) Investigators may have listed more than one reason. (B) …