RecommendationTreat-to-target recommendations in giant cell arteritisOPEN ACCESSand polymyalgia rheumaticaChristian Dejaco,2Andreas KerschbaumerDaniel AletahaMilena Bond Elvis Hysa,Dario Camellino Lisa Ehlers Andy Abril,3Simone Appenzeller,Maria C Cid Bhaskar DasguptaChristina Duftner Peter CGraysonBernhard HellmichAlojzija Hocevar516 TanazA Kermani Eric L MattesonSusan P Mollan,1920 Lorna Neill21 Cristina Ponte22.23 Carlo Salvarani24.25Sebastian Eduardo Sattui2 Wolfgang A Schmidt Philip Seo,28JosefSSmolen Jens Thie Carlos Enrique Toro-GutierrezMadeline Whitlock,32 Frank ButtgereitHandling editor Mary K CrowABSTRACTObjectives To develop treat-to-target (T2T)WHAT IS ALREADY KNOWN ON THIS TOPICAdditional supplementalmaterial is published onlinerecommendations in giant cell arteritis(GCA)andThere is large heterogeneity in clinical practiceonly.To view,please visitpolymyalgia rheumatica(PMR).related to treatment strategies in giant cellthe journal online (http://dx.Methods A systematic literature review was conductedarteritis (GCA)and polymyalgia rheumaticado1.orgy10.1136/ard-2022-to retrieve data on treatment targets and outcomes in(PMR).223429).GCA/PMR as well as to identify the evidence for theThe concept of treat-to-target (T2T)is widelyFor numbered affiliations seeeffectiveness of a T2T-based management approach inadopted in rheumatology,but has yet not beenend of article.these diseases.Based on evidence and expert opiniondefined for these diseases.the task force(29 participants from 10 countriesCorrespondence toconsisting of physicians,a healthcare professional andWHAT THIS STUDY ADDSDr Christian Dejaco,Division ofa patient)developed recommendations,with consensusHere,we present consensus-basedRheumatology and ClinicalImmuno logy,Department ofobtained through voting.The final level of agreementrecommendations on T2T in GCA and PMRInteral Medicine,Medicalwas provided anonymously.developed by an international,multidisciplinaryUniversity of Graz,Graz,8036Results Five overarching principles and six-specifictask force.Austria:recommendations were formulated.Management ofTreatment targets,as well as strategies tochristian.dejaco@gmx.netGCA and PMR should be based on shared decisionsassess,achieve and maintain these targets,Received 3 October 2022between patient and physican recognising the needhave been provided.Accepted 11 February 2023for urgent treatment of GCA to avoid ischaemiccomplications,and it should aim at maximising health-HOW THIS STUDY MIGHT AFFECT RESEARCH,related quality of life in both diseases.The treatmentPRACTICE OR POLICYtargets are achievement and maintenance of remission,These recommendations advise clinicians howas well as prevention of tissue ischaemia and vascularto effectively implement a T2T approach fordamage.Comorbidities need to be considered whenGCA and PMR in clinical practice.assessing disease activity and selecting treatment.Gaps in current knowledge have been identifiedConclusion These are the first T2T recommendati
