Treat to target in Behcet?s disease: Should we follow the paradigm of other systemic rheumatic diseases?

During the last decades the efficacy of biologic agents, mainly of anti-TNFs, in controlling the activity of serious manifestations of Behcet's Disease (BD) has been established. On the other hand, the clinical heterogeneity of BD has precluded the validation of a widely-accepted composite index for disease assessment and for target disease -state definitions, such as low disease activity and remission, and the testing of their implementation in clinical practice. Therefore, in contrast to other systemic rheumatic diseases, a treat-to-target strategy has not yet been developed in BD. There are several challenges towards this approach, including standardization of outcome measures for assessing the disease activity in each-affected organ and construction of a composite disease activity index. The challenges for the development of a treat-to-target strategy and possible solutions are discussed in this position paper, which stemmed from a round table discussion that took place in the 19th International Con-ference on BD.

Automated summary

In recent decades, the effectiveness of biologic agents, particularly anti-TNFs, in managing severe manifestations of Behcet's Disease (BD) has been established. However, the clinical heterogeneity of BD has posed challenges in validating a widely-accepted composite index for disease assessment and treatment goals. This position paper discusses the challenges and potential solutions for developing a treat-to-target strategy in BD, based on a round table discussion at the 19th International Conference on BD.