Treat to target - case series of patients with rheumatoid arthritis and no radiographic progression at long-term follow up

Rheumatoid arthritis is a chronic autoimmune inflammatory joint disease characterized by pain, morning stiffness and symmetrical polyarthritis, leading to destruction of the affected joints in long term. The goal of the treat-to-target strategy in treating the disease is to achieve remission or low disease activity. Today, there are various conventional, biological and targeted synthetic disease-modifying antirheumatic drugs (DMARDs), which are widely used in rheumatological practice in order to personalize the therapeutic strategy for each patient. One of the main goals of treatment is to suppress and slow the radiographic progression of the disease, which leads to disability, impaired quality of life and reduced work capacity of patients. There are different scales for assessing joint destruction, based on radiographic examination of small and large joints of the hands and feet, due to which we can assess structural changes in dynamics. We present three clinical cases of patients with long-standing seropositive rheumatoid arthritis, treated with conventional and/or biologic DMARDs, who achieved long-term remission and minimal radiographic progression of the disease.