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Treat-to-target in PsA: methods and necessity

Dures, Emma; Shepperd, Sasha; Mukherjee, Sandeep; Robson, Jo; Vlaev, Ivo; Walsh, Nicola; Coates, Laura C.


Emma Dures
Associate Professor in Rheumatology and Self-management

Sasha Shepperd

Sandeep Mukherjee

Jo Robson
Consultant SL in Rheumatology

Ivo Vlaev

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Nicola Walsh
Professor in Knowledge Mobilisation & Muscul

Laura C. Coates


© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. With increasing recognition of the high burden and impact of psoriatic arthritis (PsA) and the growing number of therapeutic options, there has been an intensifying focus on treatment strategy in recent years. In 2015, the Tight Control of Psoriatic Arthritis study confirmed the clinical benefit of using a treat-to-target approach in PsA. This randomised controlled trial found benefits in both arthritis and psoriasis disease activity as well as lower disease impact reported by patients, although participants allocated to tight control experienced a higher rate of serious adverse events. European and international recommendations support the use of a treat-to-target approach in PsA and have offered specific advice on how to do this using outcomes such as the minimal disease activity criteria. However, implementation of this approach in routine practice is low, with real-world data highlighting undertreatment as a result. Recent qualitative work with physicians in the UK has helped researchers to understand the barriers to implementation of treat-to-target in PsA. We now need to address these barriers, provide education and support to non-specialist clinicians in routine practice, and aid the translation of optimal care to the clinic.


Dures, E., Shepperd, S., Mukherjee, S., Robson, J., Vlaev, I., Walsh, N., & Coates, L. C. (2020). Treat-to-target in PsA: methods and necessity. RMD Open, 6(1),

Journal Article Type Review
Acceptance Date Feb 5, 2020
Online Publication Date Feb 17, 2020
Publication Date Feb 17, 2020
Deposit Date Feb 15, 2020
Publicly Available Date Mar 11, 2020
Journal RMD open
Electronic ISSN 2056-5933
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 6
Issue 1
Article Number e001083
Public URL


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