medwireNews: Some patients with rheumatoid arthritis (RA) continue to experience residual symptoms despite achieving treat-to-target (T2T) goals, but there is a paucity of evidence on the exact prevalence of these symptoms and their impact, report the authors of a systematic review.
Peter Taylor (University of Oxford, UK) and colleagues’ analysis included 53 studies investigating the nature and burden of residual disease. They found that some patients achieving low disease activity or remission continued to experience “a range of symptoms,” including functional disability, pain, fatigue, and tender or swollen joints.
However, “few studies reported the percentage of patients achieving a specific threshold, which could then be used to easily define the presence of residual symptoms,” say the researchers. They also point out that “[s]ubstantial heterogeneity among the studies made direct comparisons difficult,” with patient characteristics, study designs, outcome measures, and T2T goals varying across the studies.
These findings highlight “an unmet need, especially with respect to improving pain, fatigue, and function,” write the researchers in Arthritis Care & Research.
They say that relying solely on RA disease activity treatment targets “risks underestimating the impact [of residual disease activity] on patients’ pain, function, health, and true burden of illness,” and suggest “setting personalized goals for the individual in addition to the practice of T2T [to] inform individualized management as part of holistic care.”
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