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Treat-to-Target in Pediatric Rheumatic Diseases

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Abstract

Purpose of Review

To summarize the current evidence on the adoption of the treat-to-target (T2T) strategy in pediatric rheumatic diseases (PRD).

Recent Findings

The recent advances in the management of PRD have markedly increased the ability to achieve disease remission. Complete disease quiescence is regarded as the ideal therapeutic goal because its attainment leads to lesser long-term damage and physical disability, and to optimization of quality of life. Studies in adult rheumatic diseases have shown that patient outcomes are improved if complete suppression of the inflammatory process is aimed for by frequent adjustments of therapy according to quantitative indices. This approach, which underlies the T2T concept, has been applied in strategic trials in rheumatoid arthritis (RA). Furthermore, recommendations for the T2T have been issued for RA and other adult rheumatic diseases. There is currently a growing interest for the introduction of T2T in PRD, and recommendations for treating juvenile idiopathic arthritis (JIA) to target were promulgated. A similar initiative has been undertaken for childhood-onset systemic lupus erythematosus. Preliminary therapeutic studies have explored the T2T design in JIA.

Summary

The T2T strategy is a modern therapeutic approach that holds the promise of improving the outcomes in patients with PRD.

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Data Availability

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgements

Ana Isabel Rebollo-Giménez is holding a fellowship supported by the Sociedad Española de Reumatología.

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  1. UOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy

    Silvia Rosina, Ana Isabel Rebollo-Giménez & Alessandro Consolaro

  2. Dipartimento Di Neuroscienze, Scienze Materno-Infantili, Università Degli Studi Di Genova, RiabilitazioneGenoa, Oftalmologia, Geneticae , Italy

    Alessandro Consolaro & Angelo Ravelli

  3. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy

    Angelo Ravelli

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Rosina, S., Rebollo-Giménez, A.I., Consolaro, A. et al. Treat-to-Target in Pediatric Rheumatic Diseases. Curr Rheumatol Rep 25, 226–235 (2023). https://doi.org/10.1007/s11926-023-01112-x

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