Understanding Treat-to-Target Strategy in the Management of PsA

Announcer:
This is ReachMD. Welcome to this special series, Beyond Skin Deep: Impacts of Psoriatic Arthritis, sponsored by Lilly.

Dr. Volkmann:
Treat-to-target is a therapeutic concept that considers well-defined and specific physiologic and patient-centered targets as aims in controlling both the pathophysiology and the symptoms of a specific disease.  Typically, these targets are valid markers of disease activity, meaning that researchers have studied these biological and clinical targets across different cohorts for a specific disease, and these targets have been shown multiple times to correlate with underlying disease activity.

So in a treat-to-target strategy, we aim to reach and maintain explicitly specified and sequentially measured target goals, such as remission or low-disease activity.  These goals are different depending on the disease of interest.  For example, in a condition such as psoriatic arthritis, we aim to achieve clinical remission of disease.  This could include no tender or swollen joints, no evidence of skin psoriasis, and negative inflammatory markers. 

I think an essential component of any treat-to-target strategy is good communication between the patient and the provider.  The treatment of any disease should be based on a shared decision between the patient and their provider.  The patient should specifically be involved in refining the treat-to-target to ensure that it’s compatible with the patient’s values and preferences.  For example, one patient may value having really low disease activity in terms of their arthritis so they can function better in whatever job they do.  Another patient, it may be more important for them to have no skin disease of psoriasis.  So with any treat-to-target strategy, we try to ensure that the target we’re aiming for is something that’s clinically meaningful to the patient.

Announcer:
The preceding program was sponsored by Lilly. Content for this series is produced and controlled by ReachMD. This series is intended for healthcare professionals only. To revisit any part of this discussion and to access other episodes in this series, visit ReachMD.com/beyondskindeep. Thank you for listening. This is ReachMD. Be Part of the Knowledge.