TY - JOUR T1 - Effect of Treat-to-target Strategies Aiming at Remission of Arterial Stiffness in Early Rheumatoid Arthritis: A Randomized Controlled Study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.171128 SP - jrheum.171128 AU - Lydia Ho-Pui Tam AU - Qing Shang AU - Edmund Kwok-Ming Li AU - Priscilla Ching-Han Wong AU - Kitty Yan Kwok AU - Emily Wai-Lin Kun AU - Isaac Cheuk-Wan Yim AU - Violet Ka-Lai Lee AU - Ronald Man-Lung Yip AU - Steve Hin-Ting Pang AU - Virginia Weng-Nga Lao AU - Queenie Wah-Yan Mak AU - Isaac Tsz-Ho Cheng AU - Xerox Sze-Lok Lau AU - Tena Ka-Yan Li AU - Tracy Yaner Zhu AU - Alex Pui-Wai Lee AU - Lai-Shan Tam Y1 - 2018/05/15 UR - http://www.jrheum.org/content/early/2018/05/11/jrheum.171128.abstract N2 - Objective To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). Methods This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3.3 and Group 2 (n = 60), DAS28 < 2.6. Pulse wave velocity (PWV) and augmentation index (AIx) were measured at baseline and 12 months. A posthoc analysis was also performed to ascertain whether achieving sustained remission could prevent progression in arterial stiffness. Results The proportions of patients receiving methotrexate monotherapy were significantly lower in Group 1 throughout the study period. At 12 months, the proportions of patients achieving DAS28 and SDAI remission, and the change in PWV and AIx, were comparable between the 2 groups. In view of the lack of differences between the 2 groups, a posthoc analysis was performed at Month 12, including all 110 patients with PWV, to elucidate the independent predictors associated with the change in PWV. Multivariate analysis revealed that achieving sustained DAS28 remission at months 6, 9, and 12 and a shorter disease duration were independent explanatory variables associated with less progression of PWV. Conclusion With limited access to biologic disease-modifying antirheumatic drugs, treatment efforts toward DAS28 and SDAI remission had similar effects in preventing the progression of arterial stiffness at 1 year. However, achieving sustained DAS28 remission was associated with a significantly greater improvement in PWV. [Clinical Trial registration: Clinicaltrial.gov NCT01768923.] ER -