Treat-to-target in axial spondyloarthritis: gold standard or fools' gold?

Pedro M. Machado, Atul Deodhar

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

PURPOSE OF REVIEW: Treat-to-target (T2T) is an emerging management strategy in axial spondyloarthritis (axSpA). The concept was originally based on evidence from other chronic conditions, such as hypertension, diabetes and hypothyroidism, as well as some rheumatic diseases, such as rheumatoid arthritis and gout. The purpose of this review is to discuss the arguments against and in favour of adopting a T2T strategy in the management of axSpA. RECENT FINDINGS: International groups have recommended a T2T strategy in axSpA. Inactive disease according to the Ankylosing Spondylitis Disease Activity Score (ASDAS) has been suggested as a potential target. Achievement of ASDAS inactive disease has been associated with less progression of radiographic damage in several studies. Evidence for the benefit of a T2T approach has been published in psoriatic arthritis, a form of spondyloarthritis. SUMMARY: Observational evidence suggests that a T2T approach might be beneficial in axSpA. However, data from a prospective randomized study proving the efficacy of a T2T strategy compared to routine care are still lacking. Moreover, the cost-effectiveness of such strategy in clinical practice also needs to be tested. The target will need to be useful and feasible in both clinical practice and clinical trials.

Original languageEnglish (US)
Pages (from-to)344-348
Number of pages5
JournalCurrent opinion in rheumatology
Volume31
Issue number4
DOIs
StatePublished - Jul 1 2019

ASJC Scopus subject areas

  • Rheumatology

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