To analyze changes in medication prescribing patterns and disease activity in rheumatoid arthritis (RA) patients managed under a treat-to-target strategy over a 15-year period (2010-2025).
Key Findings:
Mean SDAI score decreased from 7.35 to 3.55 during the first SDAI period.
Methotrexate prescription rates declined from 79% to 50% over the study period.
Targeted synthetic DMARD use increased from 0% to 21%.
Mean HAQ score decreased from 0.51 to 0.37 in the second HAQ period.
SDAI remission rate increased over the follow-up period.
Interpretation:
Medication adjustments may help maintain clinical indices under a treat-to-target approach, despite changes in patient characteristics, suggesting a need for ongoing evaluation.
Limitations:
Conducted at a single medical facility in a rural area in Japan, which may limit generalizability.
Included an older cohort than other RA studies, potentially affecting outcomes.
Analysis based on monthly institutional averages, not individual drug effectiveness, which may obscure specific treatment impacts.
Educational background and economic status of patients were not assessed, which could influence results.
Conclusion:
Findings should be interpreted as associations and trends rather than evidence of causation, emphasizing the need for cautious interpretation due to the observational nature of the study.
Systematic review found robotic-assisted total hip arthroplasty improved implant positioning precision without demonstrating better patient-reported outcomes or lower complication rates than conventional surgery.
