Treat to Target

The "Treat to Target" (T2T) therapy set is a concept in the treatment of chronic diseases, especially rheumatic diseases such as rheumatoid arthritis, psoriatic arthritis and other inflammatory diseases (Kiltz U et al. 2016) . Goal-directed treatment describes a treatment paradigm that involves the selection of a clinically relevant goal, assessment with validated measures at a predetermined frequency, and a change in therapy if the goal is not achieved (Liew JW et al. 2020). The main aim of this approach is to design treatment to achieve specific, measurable goals in order to improve patients' quality of life and prevent long-term harm.

Important aspects of the "Treat to Target" approach:

• Target definition: Clear, measurable goals are defined at the start of therapy. These goals can be symptomatic (e.g. pain relief, improvement in joint mobility) or functional (e.g. achieving a certain level of activity in everyday life).
• In many cases, a goal such as "remission" or "low disease activity" is aimed for.
• Regular assessment: Patients are monitored regularly to assess progress towards the defined goals. This can be done through clinical examinations, imaging procedures or patient reports. The frequency of these assessments may vary depending on the severity of the disease and therapy.
• Therapy adjustment: If the defined goals are not achieved, the therapy is adjusted. This may include changing the medication, dosage or introducing new therapeutic approaches. These adjustments are made based on the patient's individual response to treatment.
• Patient engagement: The approach encourages the active involvement of patients in their own treatment. Information about the disease, the therapy and the importance of achieving goals is crucial. Patients are encouraged to track their symptoms and progress and actively provide feedback to their doctors.
• Multidisciplinary approach: In many cases, a team of professionals (e.g. rheumatologists, physiotherapists, psychologists) is involved to ensure comprehensive care.
• Benefits of the "Treat to Target" approach: Studies have shown that the T2T approach leads to better clinical outcomes, including a higher likelihood of remission or low disease symptomatology.

1. Kiltz U et al. (2016) "Treat-to-target (T2T)" recommendations for the treatment of patients with spondyloarthritis - translation into German [Treat-to-target (T2T). Z Rheumatol 75:903-909.
2. Liew JW et al. (2020) Treat to Target in Axial Spondyloarthritis: Pros, Cons, and Future Directions. Rheum Dis Clin North Am 46:343-356