Treat to target in spondyloarthritis: the time has come

Recent publications have proposed revisions to disease classification criteria, new definitions of early diagnosis and remission, as well as guidelines for implementing treat-to-target strategies for the management of patients with spondyloarthritis. Despite developments leading to this practice-changing approach, the concept of treat to target for spondyloarthritis has not yet been widely accepted or implemented in standard clinical care. By placing greater emphasis on clinical features that manifest early in the disease process, the early and aggressive treatment of the most common forms of spondyloarthritis (namely ankylosing spondylitis and psoriatic arthritis), has been shown to have favorable patient outcomes in reducing synovial inflammation, delaying joint damage, and maintaining functional status. This article discusses the recent concept of Treat to Target in spondyloarthritis and the importance of early diagnosis of both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). It also highlights the main outcome measures for spondyloarthritis patients achieving treatment goals of low levels of disease activity or clinical remission.