title: How low to aim in rheumatoid arthritis? Learning from other disciplines.
abstract: Treat-to-target strategies have been widely adopted as the standard of care for the management of patients with rheumatoid arthritis. The concept of 'tight control' is prevalent in other disciplines, particularly in diabetes and cardiovascular risk management. In these disciplines, evidence has accumulated that the utility of tight control strategies must be carefully weighed against the disutility that may arise from multiple interventions, particularly in patients at low risk. There is a lively debate in rheumatology circles about whether treatment should be targeted at achieving low disease activity, clinical remission or imaging remission. As rheumatologists we should learn the lessons from other disciplines, and ensure that we expand the evidence base to ensure our recommendations are securely underpinned by robust evidence.
authors.affiliation: Institute of Infection Immunity and Inflammation, University of Glasgow, , Glasgow, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Porter
authors.forename: James
authors.initials: J
authors.lastname: Dale
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D006801:Humans; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: Disease Activity; Rheumatoid Arthritis; Treatment