Psoriatic arthritis: treat-to-target

Recently, the concept of 'treat-to-target' has emerged as a topic of great interest in rheumatology, particularly as regards the therapeutic approach to patients with rheumatoid arthritis RA). From observational data as well data from controlled clinical trials, there is a body of evidence supporting this idea. Thus, closely monitoring RA patients and adjusting therapies with the goal of achieving the lowest disease activity possible can result in optimal outcomes for patients. Based on the success in RA, interest in adopting a treat-to-target approach in other rheumatic conditions, including psoriatic arthritis (PsA) has arisen. It would appear logical that some data from 'treat-to-target' approaches in RA may readily be extrapolated to PsA, particularly as it relates to PsA patients with polyarticular peripheral arthritis. However, PsA is a heterogeneous disorder, with involvement in areas quite distinct from RA, including the skin and nails, the axial spine, and the entheses. Therefore, developing a treat-to-target strategy in PsA will require additional disease specific considerations to optimise its implementation.