Rheumatoid arthritis is a chronic disease characterized by inflammation of the joints. A rapid suppression of inflammation is important for a good prognosis. Marloes Vermeer, a PhD student at the University of Twente, investigated the effects of a "Treat-to-Target treatment strategy". Ms Vermeer explains that "The new treatment appears to be feasible in daily clinical practice. Even after a period of three years, disease activity is more effectively suppressed than with conventional treatment."
Marloes Vermeer's results show that the Treat-to-Target (T2T) treatment, which is used in new rheumatoid arthritis patients, can rapidly suppress the disease in more than 55 percent of patients. This is in contrast to the use of the conventional treatment in new patients, for which the corresponding figure is 30 percent. Marloes points out that "In many patients, even after three years, T2T treatment was associated with improved physical functioning, little joint damage, and a better quality of life. In addition, the treatment is cost effective. I hope that every hospital in the Netherlands involved in treating new rheumatoid arthritis patients will use this method."
The Arthritis Center Twente (part of Medisch Spectrum Twente) launched this new treatment strategy for rheumatoid arthritis in 2006. Since then, a number of hospitals have become involved and all of the partners are now working on the Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort. The purpose of this project is to investigate the effects of the implementation of T2T. The DREAM cohort database now contains data on more than 700 patients.
T2T treatment involves regular and frequent measurements of disease activity in rheumatoid arthritis patients. These measurements include laboratory tests and clinical examinations. A score obtained by assessing 28 joints indicates the level of disease activity. If this score exceeds a given value, the medication is immediately adjusted according to a predefined medication protocol. The goal of this treatment is to totally suppress the disease (remission) as quickly as possible. This continues until the patient is symptom-free.
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