Treat to Target in Rheumatic Diseases: Rationale and Results

This issue of the Rheumatic Disease Clinics of North America has broken ground in the area of process management of our diseases. The remarkable success of the treat to target approach in rheumatoid arthritis has led to increased speculation: can it be applied to our other rheumatic diseases, which may be more heterogeneous (in some cases) or where the targets are less obvious or more multidimensional? The assumption that control of inflammation, by its very nature, can lead to the optimum result of damage prevention makes intuitive sense, but at what level is the inflammation judged to be important? Should we use highly sensitive markers of inflammation (a yet undiscovered biomarker of an MR image) to guide us beyond clinical features? These very thoughtful articles that address the conundrum we face in our heterogeneous diseases, such as axial spondyloarthritis, psoriatic arthritis, giant-cell arteritis, systemic lupus erythematosus, or myositis, what is the target that is important? Is it pain, functional disability, eliminating steroid use, or damage prevention? How does treat-to-target affect the individual patient decisions we face in daily practice? Finally, what domains are important to the patient and how does that influence the choice of targets? The more we address preclinical disease, the more the target remains elusive.
Source: Rheumatic Disease Clinics of North America - Category: Rheumatology Authors: Tags: Foreword Source Type: research