Evidence on treat to target strategies in polymyalgia rheumatica and giant cell arteritis: a systematic literature review

被引:12
作者
Hysa, Elvis [1 ,2 ]
Bond, Milena [3 ]
Ehlers, Lisa [4 ,5 ,6 ]
Camellino, Dario [7 ]
Falzon, Louise [8 ]
Dejaco, Christian [3 ,9 ,11 ,12 ]
Buttgereit, Frank [4 ,5 ,6 ]
Aletaha, Daniel [10 ]
Kerschbaumer, Andreas [10 ]
机构
[1] Univ Genoa, San Martino Polyclin, Dept Internal Med, Lab Expt Rheumatol, Genoa, Italy
[2] Univ Genoa, San Martino Polyclin, Acad Div Clin Rheumatol, Dept Internal Med, Genoa, Italy
[3] Paracelsus Med Univ, Hosp Bruneck ASAA SABES, Teaching Hosp, Dept Rheumatol, Brunico, Italy
[4] Charite Univ Med Berlin, Dept Rheumatol & Clin Immunol, Berlin, Germany
[5] Free Univ Berlin, Berlin, Germany
[6] Humboldt Univ, Berlin, Germany
[7] Local Hlth Trust 3, Div Rheumatol, Genoa, Italy
[8] Univ Sheffield, Sch Hlth & Related Res, Hlth Econ & Decis Sci, Sheffield, England
[9] Med Univ Graz, Dept Rheumatol, Graz, Austria
[10] Med Univ Vienna, Dept Med 3, Div Rheumatol, Vienna, Austria
[11] Hosp Brunico SABES ASDAA, Dept Rheumatol, Spitalstr 11, I-39031 Brunico, Italy
[12] Med Univ Graz, Auenbruggerpl 15, A-8036 Graz, Austria
关键词
GCA; PMR; treat to target; T2T; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; TIGHT-CONTROL; OPEN-LABEL; TEMPORAL ARTERITIS; METHOTREXATE; PREDNISONE; METHYLPREDNISOLONE; MULTICENTER; TOCILIZUMAB;
D O I
10.1093/rheumatology/kead471
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To inform an international task force about current evidence on Treat to Target (T2T) strategies in PMR and GCA.Methods A systematic literature research (SLR) was conducted in Medline, EMBASE, Cochrane Library, clinicaltrials.gov from their inception date to May 2022, and in the EULAR/ACR abstract database (2019-2021). Randomised clinical trials (RCTs) and non-randomised interventional studies published in English and answering at least one of the eleven PICO questions on T2T strategies, treatment targets and outcomes, framed by the taskforce, were identified. Study selection process, data extraction and risk of bias assessment were conducted independently by two investigators.Results Of 7809 screened abstracts, 397 were selected for detailed review and 76 manuscripts were finally included (31 RCTs, eight subgroup/exploratory analyses of RCTs and 37 non-randomised interventional studies). No study comparing a T2T strategy against standard of care was identified. In PMR RCTs, the most frequently applied outcomes concerned treatment (90.9% of RCTs), particularly the cumulative glucocorticoids (GC) dose and GC tapering, followed by clinical, laboratory and safety outcomes (63.3% each). Conversely, the most commonly reported outcomes in RCTs in GCA were prevention of relapses (72.2%), remission as well as treatment-related and safety outcomes (67.0% each).Conclusions This SLR provides evidence and highlights the knowledge gaps on T2T strategies in PMR and GCA, informing the task force developing T2T recommendations for these diseases.
引用
收藏
页码:285 / 297
页数:13
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