"Treat-to-Target": A Call for Earlier Targeted Intervention in Asthma

The treat-to-target approach is a concept that has been successfully implemented in many disease areas such as rheumatoid arthritis and cardiovascular disease and more recently is being discussed in asthma. Currently, asthma management is focused on severity of symptoms and disease control, with treatment approaches tailored to these symptoms versus the underlying disease activity. Although successful in many patients, there are limitations to this approach, because treatments targeting the underlying pathophysiology of disease may not be initiated until later in a patient's disease trajectory. This can leave patients with uncontrolled asthma despite high treatment doses, or initiating these treatments after long-term lung function decline has occurred. Implementing a treat-to-target approach in asthma that focuses on remission as a treatment goal advocates for a more personalized treatment approach in which the remission target offers patients and clinicians a clear benchmark for the best possible outcomes, and treatments that target the underlying pathophysiology of disease are initiated earlier in the disease course, to optimize long-term outcomes and prevent irreversible lung function decline.