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Treat-to-target in PsA: methods and necessity
Emma Dures1, Sasha Shepperd2, Sandeep Mukherjee3
1Department of Nursing and Midwifery, University of the West of England Bristol, Bristol, UK.
RMD Open
|February 20, 2020
Summary
Treating psoriatic arthritis (PsA) to target improves disease activity and patient-reported outcomes. However, real-world implementation remains low, necessitating strategies to overcome barriers and enhance optimal care delivery.
Area of Science:
- Rheumatology
- Clinical Trials
- Health Services Research
Background:
- Psoriatic arthritis (PsA) presents a significant disease burden, with evolving therapeutic options.
- The Tight Control of Psoriatic Arthritis (TCP) study in 2015 demonstrated the clinical benefits of a treat-to-target approach.
- Despite recommendations, real-world adoption of treat-to-target strategies in PsA is suboptimal, leading to undertreatment.
Purpose of the Study:
- To review the evidence supporting a treat-to-target approach in psoriatic arthritis.
- To identify barriers hindering the implementation of treat-to-target strategies in routine clinical practice.
- To propose solutions for improving the translation of optimal PsA care into clinical settings.
Main Methods:
- Review of the Tight Control of Psoriatic Arthritis (TCP) randomized controlled trial.
- Analysis of real-world data on PsA treatment patterns.
- Inclusion of recent qualitative research on physician-reported barriers in the UK.
Main Results:
- The TCP study showed benefits in arthritis and psoriasis, alongside improved patient-reported outcomes, but with increased serious adverse events.
- Real-world data indicate low implementation rates of treat-to-target approaches in PsA management.
- Qualitative research identified specific barriers faced by physicians in adopting tight control strategies.
Conclusions:
- A treat-to-target approach is clinically beneficial for managing psoriatic arthritis.
- Addressing identified barriers through education and support is crucial for improving implementation.
- Facilitating the translation of optimal care strategies into routine practice is essential for better PsA patient outcomes.
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