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

Machado, P; Deodhar, A; (2019) Treat-to-target in axial spondyloarthritis: gold standard or fools' gold? Current Opinion in Rheumatology , 31 (4) pp. 344-348. 10.1097/BOR.0000000000000625. Green open access

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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.

Type: Article
Title: Treat-to-target in axial spondyloarthritis: gold standard or fools' gold?
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/BOR.0000000000000625
Publisher version: https://doi.org/10.1097/BOR.0000000000000625
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: axial spondyloarthritis, inactive disease, outcomes research, remission, treat-to-target
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10074374
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