Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK.
Curr Rheumatol Rep. 2018 Sep 18;20(11):71. doi: 10.1007/s11926-018-0781-x.
Psoriatic arthritis (PsA) is a chronic inflammatory spondyloarthritis that can cause progressive joint damage and irreversible disability. Advances in modern therapies, now mean a target of remission is an achievable goal in PsA. There is strong and consistent evidence that a treat-to-target (T2T) approach to PsA management results in better patient outcomes; however, the practicalities of incorporating this strategy into routine clinical practice remain a challenge. The heterogeneous nature of this condition and the need for validated outcome measures have to-date hampered consensus on a definition of remission. This review aims to summarise the current T2T research landscape in PsA and highlight potential roles for biomarkers and imaging advances in revolutionising the T2T concept.
There is a growing body of evidence to support the implementation of a T2T strategy, using a pre-defined target in PsA management, with significant benefits in disease outcome, physical function and quality of life. Whilst remission is the ultimately goal for PsA patients and their clinicians, further comparative studies of different treatment targets are needed to establish a widely acceptable definition of remission.
银屑病关节炎（PsA）是一种慢性炎症性脊柱关节炎，可导致进行性关节损伤和不可逆转的残疾。现代治疗方法的进步意味着达到缓解是 PsA 的一个可实现的目标。有强有力且一致的证据表明，针对银屑病关节炎管理的达标治疗（T2T）方法可带来更好的患者结局；然而，将这一策略纳入常规临床实践的实际情况仍然具有挑战性。这种疾病的异质性以及对验证后结果测量指标的需求，迄今为止一直阻碍着对缓解定义达成共识。本篇综述旨在总结目前银屑病关节炎中的 T2T 研究现状，并强调生物标志物和影像学进展在彻底改变 T2T 概念方面的潜在作用。
越来越多的证据支持在银屑病关节炎管理中实施 T2T 策略，使用预先定义的目标，在疾病结局、身体功能和生活质量方面具有显著益处。虽然缓解是银屑病关节炎患者及其临床医生的最终目标，但需要进一步比较不同治疗目标的研究，以确定广泛接受的缓解定义。
