Clinical and radiographic outcomes at 2 years and the effect of tocilizumab discontinuation following sustained remission in the second and third year of the ACT-RAY study
Annals of the Rheumatic DiseasesPublished 29 August 2014Open access
T. Huizinga, Philip G. Conaghan, E. Martín‐Mola, Georg Schett, Howard Amital, Ricardo Machado Xavier
Citations110
SJR quartileQ1
SJR score5.73
SNIP4.44
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TL;DR
Treat-to-target strategies could be successfully implemented with TCZ to achieve sustained remission, after which TCZ was stopped.
Abstract
NCT00810199.
Keywords
Medicine
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