Key clinical point: Implementing a more stringent treat‐to‐target strategy could provide better outcomes for patients with early RA.

Major finding: At 12- and 24-month follow-up, the odds of achieving remission were greater in the ARCTIC trial than in the NOR-VEAC study (odds ratios, 1.97 and 1.82, respectively).

Study details: A comparative analysis of pooled data from the randomized ARCTIC trial and NOR-VEAC observational study.

Disclosures: The study was supported by legacy funds provided to the department of rheumatology at Diakonhjemmet Hospital in Oslo. Three authors reported financial relationships with AbbVie, Amgen, Corrona, Genentech, Janssen, Mylan, Pfizer, and other companies.

Commentary

“Treatment to target (TTT) has gained widespread acceptance as a successful evidence-based strategy in the management of RA. This article compares two Norwegian multi-center studies, both of which employed a TTT strategy, but with different targets: the ARCTIC trial used a target of DAS44 <1.6, while the NOR-VEAC trial used a less stringent target of DAS28 <2.6. The studies have different designs, limiting comparability, but overall the likelihood of reaching ACR/EULAR Boolean remission was higher in the ARCTIC study with the stricter target disease activity score, with differences seen early on, at 3 months, and persistent at 12 and 24 months. The ARCTIC study also had more frequent study visits and the protocols different on medication strategies, which limits the wider applicability of the findings.”

Arundathi Jayatilleke, MD

Lewis Katz School of Medicine, Temple University