Treat-to-target in Behçet syndrome

Behçet syndrome is a complex systemic immune-mediated form of vasculitis characterized by diverse clinical manifestations and a variable disease course. The treat-to-target (T2T) concept has emerged as a pivotal approach in managing various systemic autoimmune rheumatic diseases; however, its application in Behçet syndrome requires further work. Despite the limited literature on this subject, advancements from clinical trials have underscored the necessity for a T2T approach in Behçet syndrome. This article proposes an evidence-based perspective on the T2T strategy in Behçet syndrome, featuring a multidisciplinary and comprehensive collaboration of international experts, including rheumatologists, immunologists, ophthalmologists, gastroenterologists and neurologists. By adopting an organ-based approach to tackling crucial challenges, we aim to define treatment goals for organ involvement, discuss outcome measures that can be used as targets and definitions of remission and relapse, and also propose monitoring strategies (including treatment targets). The goal of this Perspective is to pave the way for future research and clinical practice, enhance the management of this complex condition and ultimately improve patient outcomes.