'Treat-to-target': a call for earlier targeted intervention in asthma.

The treat-to-target (TTT) approach is a concept that has been successfully implemented in many disease areas, such as rheumatoid arthritis (RA) and cardiovascular disease, and is more recently being discussed in asthma. Currently, asthma management is focused on severity of symptoms and disease control, with treatment approaches tailored to these symptoms versus the underlying disease activity. Although successful in many patients, there are limitations to this approach, as treatments targeting the underlying pathophysiology of disease may not be initiated until later on a patient's disease trajectory. This can leave patients with uncontrolled asthma despite high treatment doses, or initiating these treatments after long-term lung-function decline has already occurred. Implementing a TTT approach in asthma that focuses on remission as a treatment goal advocates for a more personalised treatment approach whereby the remission target offers patients and clinicians a clear benchmark for the best possible outcomes, and treatments that target the underlying pathophysiology of disease are initiated earlier in the disease course, to optimise long-term outcomes and prevent irreversible lung-function decline.