Treat-to-target trials keep getting harder: - rheum attitudes changed by prev trials so usual care is already v good - ?less inflamm dx - more ambitious goals ASDAS LDA/40/20 and cost-effective not enough? TICOSPA 'failed' a very high hurdle @annamolto #ACR20 ABST1444 @RheumNow https://t.co/NWSUvAtouR