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Tight Control in Rheumatoid Arthritis: Insights From Clinical Trials

Meng May Chee, MB ChB, and Duncan Porter, BM BCh

The management of rheumatoid arthritis (RA) has evolved over the last 20 years. With an ever-increasing number of treatment options including biologics, many studies have been performed to determine the optimal treatment strategy. There is increasing evidence to support “Tight Control” strategies in the management of early RA, and this has led to the development of recommendations from an international task force for a “Treat to Target” approach. Some important questions remain to be addressed – for example, how should we measure disease activity? How “low” should we aim to suppress disease activity? Are there any downsides to tight control strategies? In this article, we discuss “Tight Control” and “Treat to Target” strategies, the key evidence underpinning these concepts, and the uncertainties that remain in identifying the optimal treatment strategy. Int J Adv Rheumatol 2011;9(4):134–8.

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