Abstract: There is strong evidence from clinical trials that attainment-oriented treatment strategies are effective in relieving symptoms of rheumatoid arthritis (RA). However, the key question is whether these results can be used in daily clinical practice and achieve symptom relief in the clinical setting. OBJECTIVE: The purpose of this study was to examine whether a treatment regimen aimed at controlling a disease activity score (DAS)28<2.6 in early RA is more effective than a therapy that achieves remission with one year of conventional treatment. METHODS: Two groups of patients with early RA from different regions who met the American Rheumatism Association criteria for rheumatoid disease were compared. For the group of patients on tightly controlled therapy (n=126), a treatment approach oriented toward the goal of obtaining early control of DAS28 was used first, which began with methotrexate therapy, followed by the addition of salazosulfapyridine (SSZ) if methotrexate therapy failed, and the replacement of salazosulfapyridine (SSZ) with an antineoplastic necrosis factor drug if it failed again. Patients treated conventionally (n=126) were treated with methotrexate or SSZ, without a DAS28 attainment-oriented regimen. The primary outcome indicator was the percentage of remission (DAS28<2.6) over one year. Secondary outcome indicators were time to first symptom remission and change in DAS28. RESULTS: At one year, 55% of patients in the strict attainment-oriented treatment group had a DAS28 <2.6 (OR 3.1, 95% CI 1.8-5.2) compared to 30% of patients in the conventional treatment group. For the strict treatment group, first symptom relief occurred at 25 weeks compared to >52 weeks for the conventional treatment group (p<0.0001). DAS28 was reduced by -2.5 in the strict control group compared with -1.5 in the conventional treatment group (p<0.0001). CONCLUSION: In early rheumatoid arthritis, a tight control treatment strategy oriented to achieve remission as soon as possible resulted in more patients achieving DAS28 remission faster and a higher percentage of symptom remission at one year with this treatment regimen compared to conventional treatment.