Treating to target in rheumatoid arthritis: biologic therapies

Treating to target is an established concept in the management of a number of long-term conditions to improve outcomes and prevent disease progression. Treatment targets in rheumatoid arthritis (RA) are to control the signs and symptoms of significant inflammatory disease activity, with the ultimate goal of remission from disease. The previous article in this series (Firth, 2011) outlined treating RA to target with conventional disease modifying drugs (DMARDs), including the role of the nurse in assessing disease activity, promoting shared clinical-decision making and monitoring treatment. In recent years, biologic agents have increased the treatment options for RA, but their use is reserved for patients with severe disease activity who fail to respond to treatment with two or more DMARDs. This article outlines the role of biologic therapies in treating RA to target, including eligibility criteria and the role of the nurse in optimizing outcomes.