Table 1.

Treat to Target in Rheumatoid Arthritis recommendations.

  1. The primary target for treatment of rheumatoid arthritis should be a state of clinical remission.

  2. Clinical remission is defined as the absence of signs and symptoms of significant inflammatory disease activity.

  3. While remission should be a clear target, based on available evidence, low disease activity may be an acceptable alternative therapeutic goal, particularly in established longstanding disease.

  4. Until the desired treatment target is reached, drug therapy should be adjusted at least every 3 months.

  5. Measures of disease activity must be obtained and documented regularly, as frequently as monthly for patients with high/moderate disease activity or less frequently (such as every 3 to 6 months) for patients in sustained low disease activity or remission.

  6. The use of validated composite measures of disease activity, which include joint assessments, is needed in routine clinical practice to guide treatment decisions.

  7. Structural changes and functional impairment should be considered when making clinical decisions, in addition to assessing composite measures of disease activity.

  8. The desired treatment target should be maintained throughout the remaining course of the disease.

  9. The choice of the (composite) measure of disease activity and the level of the target value may be influenced by consideration of comorbidities, patient factors, and drug-related risks.

  10. The patient has to be appropriately informed about the treatment target and the strategy planned to reach this target under the supervision of the rheumatologist.