The "Treat to Target" Approach to Rheumatoid Arthritis

Karen Salomon-Escoto; Jonathan Kay

doi:10.1016/j.rdc.2019.06.001

The "Treat to Target" Approach to Rheumatoid Arthritis

Rheum Dis Clin North Am. 2019 Nov;45(4):487-504. doi: 10.1016/j.rdc.2019.06.001. Epub 2019 Aug 9.

Authors

Karen Salomon-Escoto¹, Jonathan Kay²

Affiliations

¹ Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA. Electronic address: Karen.salomon-escoto@umassmemorial.org.
² Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA.

PMID: 31564292
DOI: 10.1016/j.rdc.2019.06.001

Abstract

Treatment of rheumatoid arthritis has evolved significantly over the past decades. Therapeutic advances have made clinical remission a feasible goal. Systematic treatment approaches taking into account objective measures of disease activity ("treat-to-target"/"T2T") have been shown to result in better outcomes. This article reviews the latest information regarding T2T in rheumatoid arthritis, including a synopsis of the different disease activity scores available, new definitions of remission used in clinical trials and in routine clinical care, studies supporting a T2T approach, the role of imaging to guide treatment, and areas in which uncertainty remains.

Keywords: Biologics; DMARDs; Disease activity; Remission; Rheumatoid arthritis; Treat to target; Ultrasound.

Publication types

Review

MeSH terms

Arthritis, Rheumatoid / therapy*
Humans
Patient Acuity
Patient Care Management / methods*
Patient Care Planning
Remission Induction / methods