• Gerd R Burmester and Janet E Pope.
• Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany. Electronic address: gerd.burmester@charite.de.
• Lancet. 2017 Jun 10; 389 (10086): 2338-2348.

AbstractNew treatment strategies have substantially changed the course of rheumatoid arthritis. Many patients can achieve remission if the disease is recognised early and is treated promptly and continuously; however, some individuals do not respond adequately to treatment. Rapid diagnosis and a treat-to-target approach with tight monitoring and control, can increase the likelihood of remission in patients with rheumatoid arthritis. In this Series paper, we describe new insights into the management of rheumatoid arthritis with targeted therapy approaches using classic and novel medications, and outline the potential effects of precision medicine in this challenging disease. Articles are included that investigate the treat-to-target approach, which includes adding or de-escalating treatment. Rheumatoid arthritis treatment is impeded by delayed diagnosis, problematic access to specialists, and difficulties adhering to treat-to-target principles. Clinical management goals in rheumatoid arthritis include enabling rapid access to optimum diagnosis and care and the well informed use of multiple treatments approved for this disease.Copyright © 2017 Elsevier Ltd. All rights reserved.

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