Professor Maxime Dougados - EMBARK trial analysis



Professor Maxime Dougados gives a summary of the post-hoc analysis from the EMBARK trial to evalaute correlation between an acceptable status and subsequent structural deterioration.


About the speaker

Maxime Dougados is Professor of Rheumatology at Hopital Cochin, France.



Can you briefly explain what was studied and the result of the study?

Taking the opportunity to have data collected during the EMBARK trial, this study, this abstract, is summarizing the result of the post-hoc analysis aimed at evaluating whether or not there is a correlation between an acceptable status and subsequent structural deterioration. But to understand the rationale of this study, you need to come back on the concept of T-to-T; Treat-to-target approach.

There is a trend in Rheumatology and in particular in axial spondyloarthritis to use the concept of treat-to-target. The question is, “What should be the target?" In terms of outcome measure and threshold of outcome measure? And here we have evaluated as an outcome measure the ASDAS and as a threshold both remission valued below 1.3 and an acceptable status that is valued below 2.1.

In both conditions, in comparison to the other condition, that is a non-acceptable status. As soon as a patient was at a sustained acceptable status, the probability to have a structural progression was lower, suggesting that finally the choice of ASDAS as the target to use in a treat-to-target approach is of value for our clinical practice.

Why are these data important for clinical practice?

I think that concerning the impact of these results on clinical practice, it's again, to expand the concept of the treat-to-target approach to be an argument facilitating the decision by the doctor to treat according to treat-to-target approach, and by the patient to accept the concept of the treat-to-target approach. So these results are part of the cake, a piece of the cake, but they might be important for the future.


PP-ENB-GBR-0764 | March 2018