Treat-to-Target (T2T) Definition

The treat-to-target strategy has been shown to improve overall treatment results for rheumatoid arthritis.

Sometimes referred to as T2T, the treat-to-target approach has 4 essential components. Used together, they have been shown to lead to low RA disease activity or RA remission, which means few to no symptoms and less long-term joint damage.

The treat-to-target approach requires:

1. Setting a specific target

In treat-to-target, doctors and patients aim to lower RA inflammation until a specific lab test benchmark is met, such as a C-reactive protein (CRP) of less than 5 mg/L.

2. Testing regularly

Progress towards the target is measured with regular testing, which may take place every month or two. Once the benchmark goal has been reached and symptoms are well-managed, the testing may be done less frequently.

3. Changing treatment as needed

If lab test results don’t show a pattern of acceptable progress, then changes are made to the RA treatment plan. Medication dosages may be increased or drugs may be switched or added. Depending on the patient, lifestyle changes, such as quitting smoking, may be considered.

4. Sharing decision-making

The physician and patient make decisions together. The patient’s priorities and the physician’s medical expertise help inform choices about testing, reasonable goals, and treatments.

The treat-to-target approach may be adopted by anyone with rheumatoid arthritis, whether they have been recently diagnosed or have longstanding disease.

While T2T may be an effective way to reach RA remission, many patients and physicians may find it difficult to fully implement due to time constraints or other reasons.

T2T is also used to manage other chronic conditions, such as heart disease and diabetes.