Comparative Clinical Outcomes of Five Biologic and Targeted Synthetic DMARD Regimens in Rheumatoid Arthritis: A Prospective Analysis Using DAS28, MHAQ, RAPID3 and ACR Response Measures

Introduction: A variety of therapeutic medicines with different objectives have become available for Rheumatoid arthritis treatment due to a shifting therapy landscape. A treat-to-target strategy is advised by the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR). Aim of the work: This study aims to compare the clinical efficacy of different biological and targeted synthetic DMARDs in reducing disease activity and improving functional status in patients with rheumatoid arthritis.Methods: This study included 312 patients with rheumatoid arthritis (RA) diagnosed according to the ACR/EULAR 2010 rheumatoid arthritis classification criteria. Patients were recruited from the outpatient clinic and inpatient department, Rheumatology and Rehabilitation Department, Sohag University Hospitals. Patients were divided into five groups according to the type of treatment taken within 6 months of follow up. Results: Patients who received biological treatment especially Golimumab were found to have better ACR outcomes than those who received targeted synthetic DMARDs. They have less mean score in DAS28, and RAPID3 than patients receiving targeted synthetic DMARDs. On comparing the ACR outcome difference among the 5 biological treatment regimens, there was statistical difference regarding ACR50 outcome (P value=0.0001). Conclusion: In our cohort, biological DMARDs — particularly Golimumab — demonstrated superior reductions in disease activity compared to targeted synthetic DMARDs, as evidenced by significantly lower DAS28, improved mHAQ and higher ACR50 response rates. These findings support the preferential use of biologics in similar clinical settings. Key words: Rheumatoid arthritis, biological disease-modifying antirheumatic drugs, targeted synthetic disease-modifying antirheumatic drugs.