Patients will get what the patients want. Patient reported outcomes (PROs) are increasingly recognised to be more important and relevant in T2T strategies, and rightly so.
It's time to progress from precision and predictive medicine, to personalised and participatory medicine.
We may need to target a much deeper remission in order to address the functional and psychosocial issues that plague patients, beyond pain control and joint damage prevention.
Has T2T failed our patients? No, patients who resist therapy intensification when clinically indicated fail themselves. Like it's said, "You can drag a horse to the water, but you cannot make it drink."