NRAS are pleased to support this important trial
TITRATE Trial: To compare intensive management with standard care in patients with Rheumatoid Arthritis (RA) with intermediate disease activity.
Summary: The National Institute for Health Research (NIHR) is funding a pragmatic randomised controlled trial to compare intensive management with standard care in patients with Rheumatoid Arthritis showing intermediate disease activity (DAS 28-ESR 3.2-5.1). The trial takes place in different hospitals across England and is led by Professor David Scott at King’s College London and King’s College NHS Foundation Trust, London.
The trial has two arms to which patients are randomly allocated: (i) standard care and (ii) intensive management. The first aim of the study is to achieve disappearance of signs and symptoms of RA, e.g. pain, fatigue, mobility, measured by DAS28-ESR (less than 2.6) at 12 months. The secondary aims are to: (i) reduce disability, (ii) improve quality of life and (iii) show that intensive management is acceptable to patients. We will also find out the cost-effectiveness of such an approach compared with standard care.
Assessment: Patients will be screened first to see if they are eligible for the trial (based on certain criteria), and further assessments will take place at the beginning of the trial, at 6 and 12 months. These include completion of a variety of questionnaires, blood tests and x-rays of hands and feet.
Intensive Management Intervention will involve monthly reviews in the outpatient clinic where patients’ intensive treatment will be (i) reviewed and medication adjusted by a rheumatologist and (ii) supportive non-drug advice and guidance will be provided by nurses to meet each patient’s individual needs. This approach will include goal setting, skills teaching, e.g. management of pain, fatigue and physical activity, based on a specifically developed study manual. The nurses will have undergone a bespoke training to deliver this additional support.
Duration of treatment: 12 months.
Safety: Patients will be regularly monitored via blood tests.
If you need any further information about the TITRATE trial, or are interested in participating, please visit the TITRATE website (www.titrate.org.uk) for a full list of participating hospitals.
Alternatively, please contact the Trial Manager, Dr Naomi Martin, on 0207 848 5204 or firstname.lastname@example.org.
Please note that you will only be able to participate if the hospital where you are receiving your specialist treatment is involved in the trial.to see the list of participating hospitals visit the titrate website or