{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T19:21:31Z","timestamp":1794079291686,"version":"4.8.0"},"reference-count":19,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"This study is sponsored by Johnson & Johnson"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study evaluated the associations between achieving treatment goals and patient-reported outcomes (PROs) and healthcare resource utilisation (HCRU) among patients with rheumatoid arthritis (RA) on advanced treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort analyses of deidentified data from an established registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>US-based single-centre registry between 2003 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data from patients with RA in the Brigham and Women\u2019s Hospital Rheumatoid Arthritis Sequential Study registry were analysed using multivariable regression analyses. Patients were classified into four groups based on Clinical Disease Activity Index (CDAI) scores at baseline and 1\u2009year (consistently at\/not at target, gain or lose target). Patients who were consistently at target were further classified into remission, very low disease activity (LDA) and LDA subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>PROs (Multidimensional Health Assessment Questionnaire (MDHAQ) overall, pain, fatigue scores) and HCRU (surgery rates, durable medical equipment (DME) use) were assessed over 2 years.<\/jats:p>\n                    <jats:p>The primary endpoint compared MDHAQ PROs and surgery and DME HCRU among the four primary groups. The secondary endpoint assessed the association between maintaining LDA and achieving remission at follow-up with PROs and HCRU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 637\u2009patients with CDAI data, 257 (40%) had LDA at baseline; 57 (22%) lost target at 1\u2009year. Of 380 (60%) patients with CDAI &gt;10\u2009at baseline, 115 (30%) attained LDA. Patients not attaining LDA had higher surgery risk, DME use and MDHAQ scores. Of 200 (31%) patients with LDA at baseline and 1\u2009year, 89 (45%) achieved remission, 79 (40%) very LDA and 32 (16%) LDA. Remission was associated with reduced DME use (adjusted OR (AOR) 5.4 (95%\u2009CI 1.9 to 15.4)\u2009at year 1 and AOR 4.4 (95%\u2009CI 1.7 to 11.1)\u2009at year 2) and improved MDHAQ scores compared with LDA (overall unadjusted mean 0.07 vs 0.5\u2009at year 1 and 0.09 vs 0.4\u2009at year 2; p&lt;0.001), with no differences in surgery rates (AOR 1.9 (95%\u2009CI 0.7 to 5.6)\u2009at year 1 and AOR 1.9 (95%\u2009CI 0.8 to 4.4)\u2009at year 2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Achieving and maintaining LDA is challenging for patients with RA but leads to better functional outcomes and reduced DME use. Patients who achieve remission have further improvements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109286","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T12:20:24Z","timestamp":1776774024000},"page":"e109286","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Associations between achieving treatment targets and functional and economic outcomes in patients with rheumatoid arthritis: retrospective cohort analyses of BRASS registry data"],"prefix":"10.1136","volume":"16","author":[{"given":"Jing","family":"Zhao","sequence":"first","affiliation":[{"name":"Johnson & Johnson, Raritan, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urbano","family":"Sbarigia","sequence":"additional","affiliation":[{"name":"Janssen Pharmaceutica NV, Beerse, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Kwong","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Raritan, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinmayi","family":"Naik","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Zazzetti","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-845X","authenticated-orcid":false,"given":"Nancy A","family":"Shadick","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5215-5512","authenticated-orcid":false,"given":"Michael E","family":"Weinblatt","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"2026042105201265000_16.4.e109286.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)30173-8. PubMed PMID: 27156434."},{"key":"2026042105201265000_16.4.e109286.2","doi-asserted-by":"crossref","DOI":"10.3390\/cells10112857","article-title":"Management of rheumatoid arthritis: an overview","volume":"10","author":"Radu","year":"2021","journal-title":"Cells"},{"key":"2026042105201265000_16.4.e109286.3","doi-asserted-by":"crossref","first-page":"2558","DOI":"10.1007\/s12325-021-01730-w","article-title":"Healthcare costs of not achieving remission in patients with rheumatoid arthritis in the United States: a retrospective cohort study","volume":"38","author":"Bergman","year":"2021","journal-title":"Adv Ther"},{"key":"2026042105201265000_16.4.e109286.4","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1002\/acr2.11728","article-title":"Economic and humanistic burden of rheumatoid arthritis: results from the US national survey data 2018-2020","volume":"6","author":"Huang","year":"2024","journal-title":"ACR Open Rheumatol"},{"key":"2026042105201265000_16.4.e109286.5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/acr.24596","article-title":"2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"73","author":"Fraenkel","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026042105201265000_16.4.e109286.6","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223356"},{"key":"2026042105201265000_16.4.e109286.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207524"},{"key":"2026042105201265000_16.4.e109286.8","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1002\/acr.24042","article-title":"2019 Update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures","volume":"71","author":"England","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026042105201265000_16.4.e109286.9","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2023-003196","article-title":"What is the best target in a treat-to-target strategy in rheumatoid arthritis? Results from a systematic review and meta-regression analysis","volume":"9","author":"Messelink","year":"2023","journal-title":"RMD Open"},{"key":"2026042105201265000_16.4.e109286.10","article-title":"Rheumatoid arthritis disease activity assessment in routine care: performance of the most widely used composite disease activity indices and patient-reported outcome measures","volume":"92","author":"Salaffi","year":"2021","journal-title":"Acta Biomed"},{"key":"2026042105201265000_16.4.e109286.11","first-page":"S4","article-title":"Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment Questionnaire II (HAQ-II), Improved Health Assessment Questionnaire (Improved HAQ), and Rheumatoid Arthritis Quality of Life (RAQoL)","volume":"63 Suppl 11","author":"Maska","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026042105201265000_16.4.e109286.12","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4078\/jrd.2016.23.4.212","article-title":"Evidence from a Multidimensional Health Assessment Questionnaire (MDHAQ) of the value of a biopsychosocial model to complement a traditional biomedical model in care of patients with rheumatoid arthritis","volume":"23","author":"Pincus","year":"2016","journal-title":"J Rheum Dis"},{"key":"2026042105201265000_16.4.e109286.13","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2016-000391","article-title":"MDHAQ\/RAPID3 scores in patients with osteoarthritis are similar to or higher than in patients with rheumatoid arthritis: a cross-sectional study from current routine rheumatology care at four sites","volume":"3","author":"El-Haddad","year":"2017","journal-title":"RMD Open"},{"key":"2026042105201265000_16.4.e109286.14","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq263"},{"key":"2026042105201265000_16.4.e109286.15","unstructured":"Brigham and Women\u2019s Hospital . BRASS study overview. Available: https:\/\/www.brassstudy.org\/brass-information\/overview\/ [Accessed 11 Dec 2025]."},{"key":"2026042105201265000_16.4.e109286.16","unstructured":"Joint Biology Consortium . BRASS summary. Available: https:\/\/www.jbcwebportal.org\/human-biosample-core\/biorepositories\/by-institution\/ [Accessed 11 Dec 2025]."},{"key":"2026042105201265000_16.4.e109286.17","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s40674-021-00175-0","article-title":"A self-report Multidimensional Health Assessment Questionnaire (MDHAQ) for face-to-face or telemedicine encounters to assess clinical severity (RAPID3) and screen for fibromyalgia (FAST) and depression (DEP)","volume":"7","author":"Gibson","year":"2021","journal-title":"Curr Treat Options in Rheum"},{"key":"2026042105201265000_16.4.e109286.18","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(91)90027-M"},{"key":"2026042105201265000_16.4.e109286.19","doi-asserted-by":"crossref","unstructured":"Hawker GA , Mian S , Kendzerska T , et al . Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short\u2010Form McGill Pain Questionnaire (SF\u2010MPQ), Chronic Pain Grade Scale (CPGS), Short Form\u201036 Bodily Pain Scale (SF\u201036 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63. doi:10.1002\/acr.20543","DOI":"10.1002\/acr.20543"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-109286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T12:20:29Z","timestamp":1776774029000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-109286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,21]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjopen-2025-109286"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-109286","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}