Treat-to-target as an approach in inflammatory arthritis

Abstract

Treat-to-target (T2T) is a new paradigm in the treatment of rheumatoid arthritis (RA). This review is timely, because the evidence is compelling and the world's major organizations have included it in their management recommendations. T2T involves regular disease activity monitoring, ideally using the most recently described composite measures and remission criteria. The findings in the literature fully support previous notions on prevention of damage, maintenance of physical function and reduction of comorbidity risks using this strategy in early RA and have expanded these insights to established RA, elderly patients and work capacity. T2T has now even been advocated for psoriatic arthritis and is suggested of value also for ankylosing spondylitis and systemic lupus erythematosus. This paradigm is independent of the availability of particular drugs, as the strategy in itself will maximize the benefit for the patient, irrespective of specific medications. Adhering to this strategy in clinical practice will optimize the outcomes in patients with RA.