Evidence for treating rheumatoid arthritis to target: Results of a systematic literature search

Monika Schoels, Rachel Knevel, Daniel Aletaha, Johannes W J Bijlsma, Ferdinand C. Breedveld, Dimitrios T. Boumpas, Gerd Burmester, Bernard Combe, Maurizio Cutolo, Maxime Dougados, Paul Emery, Desirée Van Der Heijde, Tom W J Huizinga, Joachim Kalden, Edward C. Keystone, Tore K. Kvien, Emilio Martin-Mola, Carlomaurizio Montecucco, Maarten De Wit, Josef S. Smolen

Research output: Contribution to journalArticlepeer-review


Objectives: To summarise existing evidence on a target oriented approach for rheumatoid arthritis (RA) treatment. Methods: We conducted a systematic literature search including all clinical trials testing clinical, functional, or structural values of a targeted treatment approach. Our search covered Medline, Embase and Cochrane databases until December 2008 and also conference abstracts (2007, 2008). Results: The primary search yielded 5881 citations; after the selection process, 76 papers underwent detailed review. Of these, only seven strategic clinical trials were extracted: four studies randomised patients to routine or targeted treatment, two compared two different randomised targets and one compared targeted treatment to a historical control group. Five trials dealt with early RA patients. All identified studies showed significantly better clinical outcomes of targeted approaches than routine approaches. Disability was reported in two studies with no difference between groups. Four studies compared radiographic outcomes, two showing significant benefit of the targeted approach. Conclusion: Only few studies employed randomised controlled settings to test the value of treatment to a specific target. However, they provided unanimous evidence for benefits of targeted approaches. Nevertheless, more data on radiographic and functional outcomes and on patients with established RA are needed.

Original languageEnglish
Pages (from-to)638-643
Number of pages6
JournalAnnals of the Rheumatic Diseases
Issue number4
Publication statusPublished - Apr 2010

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy


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