Treating rheumatoid arthritis to target: an international initiative
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What do the following have in common: low-density lipoprotein (LDL), hemoglobin A1C, and blood pressure? Each is a parameter that is used as a therapeutic target in disease management: LDL for coronary artery disease (CAD), hemoglobin A1C for diabetes, and blood pressure for both diabetes and chronic kidney disease. The approach of “treating to a target” is not a new concept in clinical medicine. Indeed, such a goal-directed therapeutic strategy is already the standard approach in many specialties, and failure to achieve the set target predicts both morbidity and mortality. For example, the goal of reducing LDL is widely accepted and adhered to by both cardiologists and primary care physicians (PCPs), with the target LDL goal determined by the number of CAD risk factors that are present in an individual patient. The Joint National Commission (JNC) 7 blood pressure guidelines are also commonly followed by medical professionals. Physicians have come to recognize that blood pressures...
KeywordsRheumatoid arthritis Treatment Remission Low disease activity Treating rheumatoid arthritis to target Treat to target
E.J. Bernstein: none. A. Gibofsky: consultant to Abbott, Amgen, Pfizer, Roche, UCB, honoraria from Abbott, Amgen, Pfizer, Roche, UCB; payment for development of educational presentations from Abbott, Amgen, Pfizer, Roche, UCB; stock/stock options for Abbott, Amgen, BMS, Johnson & Johnson, Pfizer; Chair of the United States Steering Committee of the International Treat to Target Initiative. J. Kay: consultant to Centocor Ortho Biotech, Array BioPharma, Celgene, Bristol-Myers Squibb, Eisai Research Institute, UCB, Genentech, Roche, Pfizer, Mallinckrodt, Novo Nordisk, Johnson & Johnson, Sanofi-Aventis, Wyeth; member of the United States Steering Committee of the International Treat to Target Initiative.