The role of disease-modifying antirheumatic drugs in the implementation of the «treat-to-target» strategy for rheumatoid arthritis

Background. Rheumatoid arthritis is a chronic systemic autoimmune disease that remains one of the leading causes of disability worldwide. Effective management of this condition requires a modern approach focused on the early achievement of therapeutic targets, prevention of structural joint damage, and preservation of patientsʼ functional capacity. The treat-to-target strategy has proven effective but requires a deep understanding of the role of disease-modifying antirheumatic drugs, among which methotrexate, Janus kinase inhibitors, targeted therapies, and biosimilars hold key positions. Purpose – to characterize the role of disease-modifying antirheumatic drugs in the implementation of the «treat-to-target» strategy in rheumatoid arthritis. Materials and Methods. A search and content analysis of publications was conducted using PubMed, ClinicalKey, Cochrane Library, eBook Business Collection, and Google Scholar databases. Articles covering modern approaches to the treatment of rheumatoid arthritis, the efficacy and safety of different antirheumatic drugs, and the results of applying the Treat-to-Target strategy were selected. Results. Conventional synthetic disease-modifying antirheumatic drugs remain the cornerstone of therapy, with methotrexate as the first-line option. Biologic and targeted synthetic agents are used in cases of refractory disease or intolerance to baseline therapy. Implementation of the Treat-to-Target strategy is associated with achieving remission in most patients, slowing structural damage progression, and reducing disability. The effectiveness of therapy depends on regular disease activity monitoring, timely treatment adjustments, and involving patients in decision-making. Barriers to implementation include limited healthcare resources, insufficient access to innovative drugs, and the need to improve doctor-patient communication. Conclusions. The Treat-to-Target strategy, based on individualized treatment approaches and active use of disease-modifying antirheumatic drugs, forms the foundation of modern rheumatoid arthritis management. Successful implementation requires multidisciplinary collaboration, therapy accessibility, and increased patient awareness.