Bridging the gap: combining treat-to-target and difficult-to-treat strategies in the management of rheumatoid arthritis - PubMed
6 hours ago
- #difficult-to-treat
- #treat-to-target
- #rheumatoid arthritis
- The treat-to-target (T2T) strategy improves rheumatoid arthritis (RA) management by reducing undertreatment and preventing overtreatment.
- A subgroup of patients, termed 'difficult-to-treat' (D2T) RA, does not achieve predefined outcomes despite guideline-based treatment.
- D2T-RA may result from pharmacological refractoriness, psychosocial distress, comorbidities, chronic pain, or systemic barriers.
- Unnecessary treatment escalation in D2T-RA can worsen long-term outcomes if underlying factors are not identified.
- The D2T framework offers a multidomain approach for managing patients unresponsive to T2T, providing personalized, precision-medicine strategies.
- Integrating D2T into T2T practices maintains T2T strengths while addressing complex disease trajectories in RA patients.