ABSTRACT

Objective:

The “treat to target” (T2T) approach in rheumatoid arthritis increases treatment response rate. There has been a need for modification of international T2T recommendations according to the unique conditions of Turkey.

Methods:

Nine rheumatology specialists discussed original T2T recommendations in 2 meetings held in April and June 2012. Original T2T recommendations were evaluated for applicability to our country. At the end of the meetings, Turkish T2T treatment recommendations were developed.

Results:

Certain original T2T items were kept as they are in Turkish T2T. There were 3 major differences between the original and Turkish recommendations. First, outcome measures (DAS-28, SDAI, CDAI, RAPID-3) were indicated in Turkish T2T recommendations. Second difference was related to the assessment of treatment efficacy. Original T2T recommended that patients should be followed in 3 months intervals; however, Turkish T2T recommended 3-6 months intervals instead. The third difference is in the 8th recommendation. If the patients were in remission or in stable disease activity state, patients may be followed with 6 month intervals by rheumatology specialists. The same recommendation also advised to do control of drug safety by a general practitioner, an internal medicine specialist or another specialist.

Conclusion:

Majority of the original T2T recommendations were found applicable to our country. However, taking into account the low number of rheumatology specialists in Turkey, certain modifications were suggested about intervals of patient follow-up in the Turkish T2T recommendations.