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Today's session, Treat to target in axSpA: reality or utopia?, was opened with a presentation by Dr. Jurgen Braun (Herne, Germany), who masterfully reintroduced us to the treat-to-target concept in spondyloarhtropathies.
Similar to how diabetes control and outcomes improved with introduction of treat to target concept in endocrinology, rheumatologists are looking to adopt similar strategies for more effective management of rheumatic disease outcomes.
In his presentation today Dr. Braun raised two important questions:
what is the target in treatment of rheumatic diseases? and
is T2T applicable in SpA?
While more easily defined in rheumatoid arthritis, remission is a more complicated target in SpA with axial involvement. The majority of published studies conclude that overall mortality and morbidity in SpA is linked to disease activity. Longitudinal relationship as observed between disease activity and radiographic damage over time:
Existent treatment guidelines are helpful in achieving treatment. When used in T2T approach, ASDAS showed to be effective outcome measure in axSpA comparable to DAS in RA.
Dr. Braun concluded that T2T can be effectively used in SpA and patients would benefit if rheumatologists follow this concept.