Treating to Target in Psoriatic Arthritis

Laura C. Coates

Disclosures

Curr Opin Rheumatol. 2015;27(2):107-110. 

In This Article

Abstract and Introduction

Abstract

Purpose of review Psoriatic arthritis (PsA) is an inflammatory arthritis causing significant joint damage and impaired quality of life. A treat to target approach has revolutionized the care of patients with rheumatoid arthritis over the last decade. There is now increasing interest in a similar approach in PsA, as it seems that ongoing joint inflammation predicts subsequent damage and loss of function.

Recent findings A 2011 European League Against Rheumatism review highlighted a lack of evidence for treat to target in PsA. However, with the development of the minimal disease activity criteria, a target is available and preliminary results from the first randomized treat-to target study (Tight Control of PsA Study) using these criteria have shown significant benefit in joint and skin disease activity and patient-reported outcomes.

Summary Early evidence has shown the potential benefit of a treat-to-target approach in PsA and further research is needed to optimize treatment pathways for all subtypes of the disease.

Introduction

Tailoring a patient's therapy aiming for a predefined target has rapidly translated from research studies in rheumatoid arthritis to clinical practice over the last decade. The overwhelming evidence for the benefits of this approach[1] have led to adoption of the practice embedded within new randomized clinical trials of therapies and crucially in routine outpatient care. Following this success, there has been increasing interest in such an approach in other inflammatory arthritis including psoriatic arthritis. This review aims to address what defines a treat-to-target approach, what evidence exists for possible treatment targets in psoriatic arthritis, the evidence for treating to target in psoriatic arthritis (PsA) and issues specific to PsA that should be considered within this treatment strategy.

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