Treat to target in psoriatic arthritis-evidence, target, research agenda

Abstract

This article summarises the evidence on treating to target (T2T) in psoriatic arthritis (PsA). The evidence from the recent European League Against Rheumatism (EULAR) literature search in SpA is reviewed. This article found no studies in SpA in 2011 which compared a T2T approach against standard care in a randomised controlled trial (RCT). One of the issues raised in PsA is what target to use. The minimal disease activity (MDA) criteria were developed specifically for PsA and have been validated in observational and interventional cohorts. These have now been utilised in the Tight Control of PsA (TICOPA) study comparing T2T to standard care in early PsA providing the first evidence that T2T in PsA can improve outcomes. To translate this into clinical practice in PsA, patient education and feasibility are key. Future research must address the optimal therapies to be used within a T2T framework which will need to take subtype of PsA into account.