Safety, efficacy, and mortality in a long-term cohort of patients with rheumatoid arthritis taking methotrexate: Followup after a mean of 13.3 years
Safety, efficacy, and mortality in a long-term cohort of patients with rheumatoid arthritis taking methotrexate: Followup after a mean of 13.3 years
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DOI：
10.1002/art.1780400533
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发表时间：
1997-05-01
影响因子：
--
通讯作者：
Kremer, JM
中科院分区：
文献类型：
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作者：
Kremer, JM
我们最近才开始意识到类风湿性关节炎（RA）不是一种完全良性的疾病。Pincus（1）和Wolfe et a1（2）均表明，“大多数RA患者在长时间内经历疾病进展，伴有早期放射学损伤、功能下降、工作残疾和过早死亡率”（1）。它还指出，“在5-10年的中期明显改善”可能会出现在传统的结果指标，如招标关节的数量，即使患者在这些相同的时期经历“功能状态大幅下降”（1，3）。非常长期的观察性研究是罕见的风湿性疾病，因为资金和后勤方面的考虑。在同一时期，我们已经获得了关于RA患者目前公认的普遍不良结局的见解，处方模式发生了变化，MTX现在使用得更早，更普遍。因此，对MTX治疗的活动性RA患者进行长期研究是有意义的，以确定关于这种疾病的一般结局的见解是否也适用于MTX治疗的患者。
We have only recently begun to appreciate that rheumatoid arthritis (RA) is not an entirely benign disease. Pincus (1) and Wolfe et a1 (2) have both shown that “most patients with RA experience a progressive disease over long periods, with early radiographic damage, functional declines, work disability, and premature mortality rates”(1). It is also stated that “apparent improvement over intermediate periods of 5-10 years” may be seen in traditional outcome measures, such as the number of tender joints, even while patients experience “substantial declines in functional status” during these same periods (1, 3).Very long-term observational studies are uncommon in the rheumatic diseases because of both funding and logistical considerations. Over the same period that we have gained insights about the generally poor outcomes now recognized in RA patients, there has been a change in prescribing patterns, with MTX now used earlier and more commonly. Thus, long-term studies in patients with active RA treated with MTX are of interest in order to determine whether the insights about the general outcomes of this disease also apply to patients treated with MTX.